Potential Hypoglycemic Effect of Pomegranate Juice and Its Mechanism of Action: A Systematic Review

Abstract

Pomegranate juice (PJ) has gained popularity attributed to its phenolic compounds and their medicinal properties. Its potential hypoglycemic effect has been related to enzymatic inhibition, insulin release, and the protection of pancreatic tissue. These effects depend on several aspects, such as the content and composition of phenols in pomegranate and characteristics of the organism that consumes the juice. The objective of this study was to systematically review scientific evidence investigating the hypoglycemic effect of PJ; the factors that affect bioactive compounds; and the mechanisms of action attributed to this effect. Human and rodent in vivo and in vitro studies were retrieved from PubMed, Scopus, and ScienceDirect databases. After reviewing the articles, it was identified that the methodologies and results among the scientific evidence were quite heterogeneous. Despite these limitations, many of the in vivo and in vitro studies found important hypoglycemic effects from PJ, as well as an increase in the function of b-cell, insulin secretion, a significantly lower activity of a-amylase enzyme, an inhibition of the enzyme a-glucosidase and dipeptidyl peptidase-4 (DPP-4), and the protection against DNA damage. Determining the potential health benefits of polyphenols contained in the pomegranate is limited for multiple factors that could affect the efficacy of PJ. Overall, the results of this review suggest the need for further experimentation, using controlled variable factors and testing the effect of PJ under similar experimental conditions.

Ellagic Acid: A Review on Its Natural Sources, Chemical Stability, and Therapeutic Potential

“…A 2020 systematic review on the hypoglycemic effect of pomegranate by Virgen-Carrillo et al [300] revealed that the evidence's methodology is heterogeneous, including study design and intervention characteristics. The studies' patients varied widely in clinical features: healthy, obese, diabetic people, metabolic syndrome, cardiovascular pathologies, and women with polycystic ovarian syndrome [300].…”

Recent Developments in Inonotus obliquus (Chaga mushroom) Polysaccharides: Isolation, Structural Characteristics, Biological Activities and Application

“…It could be affected by monosaccharide composition, molecular weight, branched chain structure, high-level structure, etc. Existing studies have found that the mechanisms of polysaccharides for hypoglycemic activity mainly include regulation of enzyme activity, liver glucose metabolism, intestinal flora, protection and reparation of pancreatic islet cells, and improvement of insulin sensitivity [ 105 , 106 , 107 , 108 , 109 ].…”

“…α-Amylase and α-glucosidase are enzymes that promote the breaking of α-1,4-glycosidic bonds in starch, maltose, sucrose and oligosaccharides and hydrolyze them into monosaccharide that are easy to digest and be absorbed by the human body, such as glucose [ 106 ]. This caused the postprandial blood glucose levels of diabetic patients to increase and insulin sensitivity to be reduced, even lead them to serious complications and aggravate the condition [ 110 ].…”

Potential Mechanisms of the Improvement of Glucose Homeostasis in Type 2 Diabetes by Pomegranate Juice

“…The work suggested that pome granate juice polyphenols could reduce the postprandial glycemic response of bread. Ad ditionally, punicalagin was an effective in vitro inhibitor of human α-amylase to the drug acarbose, a drug which acts by inhibiting human α-amylase [54,55], while ellagic acid and punicalin were less effective [14].…”

“…Pomegranate polyphenols like ellagic acid and punicalagin appear to have inhibitory effects on the activity of α-amylase, α-glucosidase, and dipeptidyl peptidase-4 in free-cell systems and adipocyte cell lines. The polyphenols act as α-amylase inhibitors like the drug acarbose [54,55]. Bellesia et al [64] demonstrated that ellagic acid and punicalagin (exclusive to pomegranate) inhibited α-glucosidase [64].…”