Review
Polyphenols and Their Role in Obesity Management: A Systematic Review of Randomized Clinical Trials
Grace Farhat,
Sandra Drummond,
Emad A.S. Al-Dujaili,
Corresponding Author
Grace Farhat
Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Musselburgh, East Lothian, EH21 6UU UK
Correspondence to: Grace Farhat, Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Musselburgh, East Lothian, EH21 6UU, UK.
E-mail: [email protected]
Search for more papers by this authorSandra Drummond
Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Musselburgh, East Lothian, EH21 6UU UK
Search for more papers by this authorEmad A.S. Al-Dujaili
Faculty of Pharmacy, Middle East University, Amman, Jordan
Search for more papers by this authorGrace Farhat,
Sandra Drummond,
Emad A.S. Al-Dujaili,
Corresponding Author
Grace Farhat
Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Musselburgh, East Lothian, EH21 6UU UK
Correspondence to: Grace Farhat, Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Musselburgh, East Lothian, EH21 6UU, UK.
E-mail: [email protected]
Search for more papers by this authorSandra Drummond
Department of Dietetics, Nutrition and Biological Sciences, Queen Margaret University, Musselburgh, East Lothian, EH21 6UU UK
Search for more papers by this authorEmad A.S. Al-Dujaili
Faculty of Pharmacy, Middle East University, Amman, Jordan
Search for more papers by this authorAbstract
Polyphenols have been suggested to reduce body weight and modify body composition through different mechanisms. These effects have been extensively studied in animals and in vitro and to a lesser extent in humans. The aim of this review is to consider the association between polyphenols and body weight status by focusing on human intervention studies. We conducted a systematic literature search in MEDLINE (via EBSCOhost), ProQuest CENTRAL, and Cochrane CENTRAL without time restrictions. Randomized controlled trials assessing the effect of polyphenols on weight and/or body composition in the overweight and/or obese population were included. Nineteen studies met our inclusion criteria. Results suggest that further research is required before supporting a potential role of polyphenols in reducing weight in overweight and obese individuals (nine studies showed a significant decrease in weight by a mean of 1.47 ± 0.58 kg). Nevertheless, several studies indicated that polyphenols might be effective in preventing small increases in weight during periods of overfeeding rather than reducing weight as such. The outcomes noted do not yet support polyphenol supplementation as a complementary approach in weight loss diets. Further larger trials with a duration of 12 months or more are needed to elucidate the effect of polyphenols on body weight status. Copyright © 2017 John Wiley & Sons, Ltd.
References
- Ahn J, Lee H, Kim S, Park J, Ha T. 2008. The anti-obesity effect of quercetin is mediated by the AMPK and MAPK signaling pathways. Biochem Bioph Res C 373: 545–549.
- Akaberi M, Hosseinzadeh H. 2016. Grapes (Vitis vinifera) as a potential candidate for the therapy of the metabolic syndrome. Phytother Res 30: 540–556.
- Akazome Y, Kametani N, Kanda T, Shimasaki H, Kobayashi S. 2010. Evaluation of safety of excessive intake and efficacy of long-term intake of beverages containing apple polyphenols. J Oleo Sci 59: 321–338.
- Almoosawi S, Tsang C, Ostertag LM, Fyfe L, Al-Dujaili EA. 2012. Differential effect of polyphenol-rich dark chocolate on biomarkers of glucose metabolism and cardiovascular risk factors in healthy, overweight and obese subjects: a randomized clinical trial. Food Funct 3: 1035–1043.
- Barth SW, Koch TC, Watzl B, Dietrich H, Will F, Bub A. 2012. Moderate effects of apple juice consumption on obesity-related markers in obese men: impact of diet–gene interaction on body fat content. EJCN 51: 841–850.
- Basu A, Sanchez K, Leyva MJ, et al. 2010. Green tea supplementation affects body weight, lipids, and lipid peroxidation in obese subjects with metabolic syndrome. J Am Coll Nutr 29: 31–40.
- Bell ZW, Canale RE, Bloomer RJ. 2011. A dual investigation of the effect of dietary supplementation with licorice flavonoid oil on anthropometric and biochemical markers of health and adiposity. Lipids Health Dis 10: 1. Epub ahead of print. https://doi.org/10.1186/1476-511X-10-29.
- Brown AL, Lane J, Holyoak C, Nicol B, Mayes AE, Dadd T. 2011. Health effects of green tea catechins in overweight and obese men: a randomised controlled cross-over trial. BJN 106: 1880–1889.
- Chang HC, Peng CH, Yeh DM, Kao ES, Wang CJ. 2014. Hibiscus sabdariffa extract inhibits obesity and fat accumulation, and improves liver steatosis in humans. Food Funct 5: 734–739.
- Chen YC, Cypess AM, Chen YC, et al. 2013. Measurement of human brown adipose tissue volume and activity using anatomic MR imaging and functional MR imaging. J Nucl Med 54: 1584–1587.
- Cornell University library. A guide to conducting systematic reviews: steps in a systematic review. Version current. 18 August 2016. Internet: http://guides.library.cornell.edu/c.php?g=459012&p=3142201 (accessed 17 December 2016).
- D'Archivio M, Filesi C, Di Benedetto R, Gargiulo R, Giovannini C, Masella R. 2007. Polyphenols, dietary sources and bioavailability. Annali-Istituto Superiore di Sanita 43: 38–61.
- Dallas C, Gerbi A, Elbez Y, Caillard P, Zamaria N, Cloarec M. 2014. Clinical study to assess the efficacy and safety of a citrus polyphenolic extract of red orange, grapefruit, and orange (Sinetrol-XPur) on weight management and metabolic parameters in healthy overweight individuals. Phytother Res 28: 212–218.
- Daniel EM, Krupnick AS, Heur YH, Blinzler JA, Nims RW, Stoner GD. 1989. Extraction, stability, and quantitation of ellagic acid in various fruits and nuts. J Food Compos Anal 2: 338–349.
- Di Renzo L, Rizzo M, Sarlo F, et al. 2013. Effects of dark chocolate in a population of normal weight obese women: a pilot study. Eur Rev Med Pharmacol Sci 17: 2257–2266.
- Dorenkott MR, Griffin LE, Goodrich KM, et al. 2014. Oligomeric cocoa procyanidins possess enhanced bioactivity compared to monomeric and polymeric cocoa procyanidins for preventing the development of obesity, insulin resistance, and impaired glucose tolerance during high-fat feeding. J Agr Food Chem 62: 2216–2227.
- Dudzińska D, Boncler M, Watala C. 2015. The cardioprotective power of leaves. AMS 11: 819–839.
- Dulloo AG, Duret C, Rohrer D, et al. 1999. Efficacy of green tea extracts rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. AJCN. 70: 1040–1045.
- Ejaz A, Wu D, Kwan P, Meydani M. 2009. Curcumin inhibits adipogenesis in 3T3-L1 adipocytes and angiogenesis and obesity in C57/BL mice. J Nutr 139: 919–925.
- Etcheverry P, Grusak MA, Fleige LE. 2012. Application of in vitro bioaccessibility and bioavailability methods for calcium, carotenoids, folate, iron, magnesium, polyphenols, zinc, and vitamins B6, B12, D, and E. Frontiers in Physiology 3: 317. Epub ahead of print. https://doi.org/10.3389/fphys.2012.00317.
- Farhat G, Drummond S, Fyfe L, McDougall G, Al-Dujaili EA. 2015. Comparison of the effects of high versus low-polyphenol dark chocolate on body weight and biochemical markers: a randomized trial. EC Nutrition 2: 354–364.
- Ganjali S, Blesso CN, Banach M, Pirro M, Majeed M, Sahebkar A. 2017. Effects of curcumin on HDL functionality. Pharmacol Res 119: 208–218.
- Golomb BA, Koperski S, White HL. 2012. Association between more frequent chocolate consumption and lower body mass index. Arch Intern Med 172: 519–521.
- González-Ortiz M, Martínez-Abundis E, Espinel-Bermúdez MC, Pérez-Rubio KG. 2011. Effect of pomegranate juice on insulin secretion and sensitivity in patients with obesity. Ann Nutr Metab 58: 220–223.
- Gu Y, Hurst WJ, Stuart DA, Lambert JD. 2011. Inhibition of key digestive enzymes by cocoa extracts and procyanidins. J Agr Food Chem 59: 5305–5311.
- Gu Y, Yu S, Lambert JD. 2014. Dietary cocoa ameliorates obesity-related inflammation in high fat-fed mice. EJCN 53: 149–158.
- Gulvady AA, Ciolino HP, Cabrera RM, Jolly CA. 2013. Resveratrol inhibits the deleterious effects of diet-induced obesity on thymic function. J Nutr Biochem 24: 1625–1633.
- Hamman RF, Wing RR, Edelstein SL, et al. 2006. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 29: 2102–2107.
- Headland M, Clifton PM, Carter S, Keogh JB. 2016. Weight-loss outcomes: a systematic review and meta-analysis of intermittent energy restriction trials lasting a minimum of 6 months. Forum Nutr 8: E354. Epub ahead of print. https://doi.org/10.3390/nu8060354.
- Hollis JH, Houchins JA, Blumberg JB, Mattes RD. 2009. Effects of concord grape juice on appetite, diet, body weight, lipid profile, and antioxidant status of adults. J Am Coll Nutr 28: 574–582.
- Hsu CH, Tsai TH, Kao YH, Hwang KC, Tseng TY, Chou P. 2008. Effect of green tea extract on obese women: a randomized, double-blind, placebo-controlled clinical trial. Clin Nutr 27: 363–370.
- Hsu CL, Yen GC. 2007. Effects of flavonoids and phenolic acids on the inhibition of adipogenesis in 3T3-L1 adipocytes. J Agr Food Chem 55: 8404–8410.
- Hughes LA, Arts IC, Ambergen T, et al. 2008. Higher dietary flavone, flavonol, and catechin intakes are associated with less of an increase in BMI over time in women: a longitudinal analysis from the Netherlands cohort study. Am J Clin Nutr 88: 1341–1352.
- Hursel R, Viechtbauer W, Westerterp-Plantenga MS. 2009. The effects of green tea on weight loss and weight maintenance: a meta-analysis. Int J Obesity 33: 956–961.
- Hurst WJ, Glinski JA, Miller KB, Apgar J, Davey MH, Stuart DA. 2008. Survey of the trans-resveratrol and trans-piceid content of cocoa-containing and chocolate products. J Agr Food Chem 56: 8374–8378.
- Izzo AA, Hoon-Kim S, Radhakrishnan R, Williamson EM. 2016. A critical approach to evaluating clinical efficacy, adverse events and drug interactions of herbal remedies. Phytother Res 30: 691–700.
- Jousilahti P, Tuomilehto J, Vartiainen E, Pekkanen J, Puska P. 1996. Body weight, cardiovascular risk factors, and coronary mortality 15-year follow-up of middle-aged men and women in eastern Finland. Circulation 93: 1372–1379.
- Jung HA, Jung HJ, Jeong HY, Kwon HJ, Ali MY, Choi JS. 2014. Phlorotannins isolated from the edible brown alga Ecklonia stolonifera exert anti-adipogenic activity on 3T3-L1 adipocytes by downregulating C/EBPα and PPARγ. Fitoterapia 92: 260–269.
- Krzysztoszek J, Wierzejska E, Zielinska A. 2015. Obesity. An analysis of epidemiological and prognostic research. AMS 11: 24–33.
- Kunnumakkara AB, Bordoloi D, Padmavathi G, et al. 2016. Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases. Br J Pharmacol Epub ahead of print. https://doi.org/10.1111/bph.13621.
- Lei F, Zhang XN, Wang W, et al. 2007. Evidence of anti-obesity effects of the pomegranate leaf extract in high-fat diet induced obese mice. Int J Obesity 31: 1023–1029.
- Leibel RL. 2008. Molecular physiology of weight regulation in mice and humans. Int J Obesity 32: S98–S108.
- Manach C, Scalbert A, Morand C, Rémésy C, Jiménez L. 2004. Polyphenols: food sources and bioavailability. AJCN 79: 727–747.
- Martin KR, Appel CL. 2010. Polyphenols as dietary supplements: a double-edged sword. Nutr Diet Suppl 2: 1–2.
- Matsui N, Ito R, Nishimura E, et al. 2005. Ingested cocoa can prevent high-fat diet-induced obesity by regulating the expression of genes for fatty acid metabolism. Nutrition 21: 594–601.
- McDougall GJ, Stewart D. 2005. The inhibitory effects of berry polyphenols on digestive enzymes. Biofactors 23: 189–195.
- Meydani M, Hasan ST. 2010. Dietary polyphenols and obesity. Forum Nutr 2: 737–751.
- Michalska M, Gluba A, Mikhailidis DP, et al. 2010. The role of polyphenols in cardiovascular disease. Med Sci Monit 16: RA110–RA119.
- Min SY, Yang H, Seo SG, et al. 2013. Cocoa polyphenols suppress adipogenesis in vitro and obesity in vivo by targeting insulin receptor. Int J Obesity 37: 584–592.
- Moher D, Liberati A, Tetzlaff J, Altman DG. 2009. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151: 264–269.
- Nagao T, Hase T, Tokimitsu I. 2007. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity 15: 1473–1483.
- Nagao T, Komine Y, Soga S, et al. 2005. Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. AJCN 81: 122–129.
- Natsume M, Osakabe N, Oyama M, et al. 2003. Structures of (−)-epicatechin glucuronide identified from plasma and urine after oral ingestion of (−)-epicatechin: differences between human and rat. Free Radical Bio Med 34: 840–849.
- Nomura S, Ichinose T, Jinde M, Kawashima Y, Tachiyashiki K, Imaizumi K. 2008. Tea catechins enhance the mRNA expression of uncoupling protein 1 in rat brown adipose tissue. J Nutr Biochem 19: 840–847.
- Osakabe N. 2013. Flavan 3-ols improve metabolic syndrome risk factors: evidence and mechanisms. J Clin Biochem Nutr 52: 186–192.
- Panickar KS. 2013. Effects of dietary polyphenols on neuroregulatory factors and pathways that mediate food intake and energy regulation in obesity. Mol Nutr Food Res 57: 34–47.
- Patti AM, Toth PP, Giglio RV, et al. 2017. Nutraceuticals as an important part of combination therapy in dyslipidaemia. Curr Pharm Des Epub ahead of print. https://doi.org/10.2174/1381612823666170317145851.
- Pfeuffer M, Auinger A, Bley U, et al. 2013. Effect of quercetin on traits of the metabolic syndrome, endothelial function and inflammation in men with different APOE isoforms. Nutr Metab Cardiovas 23: 403–409.
- Poulsen MM, Vestergaard PF, Clasen BF, et al. 2013. High-dose resveratrol supplementation in obese men an investigator-initiated, randomized, placebo-controlled clinical trial of substrate metabolism, insulin sensitivity, and body composition. Diabetes 62: 1186–1195.
- Rangel-Huerta OD, Aguilera CM, Martin MV, et al. 2015. Normal or high polyphenol concentration in orange juice affects antioxidant activity, blood pressure, and body weight in obese or overweight adults. J Nutr 145: 1808–1816.
- Santini A, Novellino E. 2016. Nutraceuticals in hypercholesterolaemia: an overview. Br J Pharmacol Epub ahead of print. https://doi.org/10.1111/bph.13636.
- Seo MJ, Lee YJ, Hwang JH, Kim KJ, Lee BY. 2015. The inhibitory effects of quercetin on obesity and obesity-induced inflammation by regulation of MAPK signaling. J Nutr Biochem 26: 1308–1316.
- Serban C, Sahebkar A, Ursoniu S, Andrica F, Banach M. 2015. Effect of sour tea (Hibiscus sabdariffa L.) on arterial hypertension: a systematic review and meta-analysis of randomized controlled trials. J Hypertens 33: 1119–1127.
- Shao W, Yu Z, Chiang Y, et al. 2012. Curcumin prevents high fat diet induced insulin resistance and obesity via attenuating lipogenesis in liver and inflammatory pathway in adipocytes. PLoS One [serial online] 7: e28784. Internet: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0028784&type=printable (accessed 20 December 2016).
- Shimoda H, Tanaka J, Kikuchi M, et al. 2009. Effect of polyphenol-rich extract from walnut on diet-induced hypertriglyceridemia in mice via enhancement of fatty acid oxidation in the liver. J Agr Food Chem 57: 1786–1792.
- Shin HC, Kim SH, Park Y, Lee BH, Hwang HJ. 2012. Effects of 12-week oral supplementation of Ecklonia cava polyphenols on anthropometric and blood lipid parameters in overweight Korean individuals: a double-blind randomized clinical trial. Phytother Res 26: 363–368.
- Smeriglio A, Barreca D, Bellocco E, Trombetta D. 2016. Chemistry, pharmacology and health benefits of anthocyanins. Phytother Res 30: 1265–1286.
- Stevens J, Truesdale KP, McClain JE, Cai J. 2006. The definition of weight maintenance. Int J Obes (Lond) 30: 391–399.
- Stohs SJ, Badmaev V. 2016. A review of natural stimulant and non-stimulant thermogenic agents. Phytother Res 30: 732–740.
- Suliburska J, Bogdanski P, Szulinska M, Stepien M, Pupek-Musialik D, Jablecka A. 2012. Effects of green tea supplementation on elements, total antioxidants, lipids, and glucose values in the serum of obese patients. Biol Trace Elem Res 149: 315–322.
- Tian C, Ye X, Zhang R, et al. 2013. Green tea polyphenols reduced fat deposits in high fat-fed rats via erk1/2-PPARγ-adiponectin pathway. PLoS One [serial online] 8: e53796. Internet: http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC3546082&blobtype=pdf (accessed 20 December 2016).
- Tominaga Y, Mae T, Kitano M, Sakamoto Y, Ikematsu H, Nakagawa K. 2006. Licorice flavonoid oil effects body weight loss by reduction of body fat mass in overweight subjects. J Health Sci 52: 672–683.
- Tominaga Y, Nakagawa K, Mae T, et al. 2009. Licorice flavonoid oil reduces total body fat and visceral fat in overweight subjects: a randomized, double-blind, placebo-controlled study. Obes Res Clin Pract 3: 169–178.
- Verweij LM, Terwee CB, Proper KI, Hulshof CT, van Mechelen W. 2013. Measurement error of waist circumference: gaps in knowledge. Public Health Nutr 16: 281–288.
- Wang H, Wen Y, Du Y, et al. 2010. Effects of catechin enriched green tea on body composition. Obesity 18: 773–779.
- Westerterp-Plantenga MS, Lejeune MP, Kovacs EM. 2005. Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation. Obes Res 13: 1195–1204.
- WHO. 2016. Obesity and overweight. Internet: http://www.who.int/mediacentre/factsheets/fs311/en/ (accessed 20 February 2017).
- Wu CH, Lu FH, Chang CS, Chang TC, Wang RH, Chang CJ. 2003. Relationship among habitual tea consumption, percent body fat, and body fat distribution. Obes Res 11: 1088–1095.
- Zaki ME, El-Bassyouni HT, El-Gammal M, Kamal S. 2015. Indicators of the metabolic syndrome in obese adolescents. Arch Med Sci 11: 92–98.
