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Pomegranate juice supplementation in chronic obstructive pulmonary disease: a 5-week randomized, double-blind, placebo-controlled trial



The aim of the present study is to investigate the effect of antioxidant polyphenol-rich pomegranate juice (PJ) supplementation for 5 weeks on patients with stable chronic obstructive pulmonary disease (COPD), since the oxidative stress plays a major role in the evolution and pathophysiology of COPD.


A randomized, double-blind, placebo-controlled trial was conducted.


A total of 30 patients with stable COPD were randomly distributed in two groups (15 patients each).


Both groups consumed either 400 ml PJ daily or matched placebo (synthetic orange-flavoured drink) for 5 weeks. Trolox Equivalent Antioxidant Capacity (TEAC) of PJ, blood parameters (14 haematological and 18 serobiochemical), respiratory function variables, bioavailability of PJ polyphenols (plasma and urine) and urinary isoprostane (8-iso-PGF2α) were evaluated.


The daily dose of PJ (containing 2.66 g polyphenols) provided 4 mmol/l TEAC. None of the polyphenols present in PJ were detected in plasma or in urine of volunteers. The most abundant PJ polyphenols, ellagitannins, were metabolized by the colonic microflora of COPD patients to yield two major metabolites in both plasma and urine (dibenzopyranone derivatives) with no TEAC. No differences were found (P>0.05) between PJ and placebo groups for any of the parameters evaluated (serobiochemical and haematological), urinary 8-iso-PGF2α, respiratory function variables and clinical symptoms of COPD patients.


Our results suggest that PJ supplementation adds no benefit to the current standard therapy in patients with stable COPD. The high TEAC of PJ cannot be extrapolated in vivo probably due to the metabolism of its polyphenols by the colonic microflora. The understanding of the different bioavailability of dietary polyphenols is critical before claiming any antioxidant-related health benefit.


‘Fundación Séneca’ (Murcia, Spain), Project PB/18/FS/02 and Spanish CICYT, Project AGL2003-02195.

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BC has a fellowship from the Spanish ‘Consejo Superior de Investigaciones Científicas’ (CSIC) and ESF (I3P Program). We are grateful to Ms Ana María Hita, Ms Mari Carmen Garay and Ms María José Salmerón from the ‘Virgen de La Arrixaca University Hospital’ (Murcia, Spain) for their assistance in some parts of this study.

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Correspondence to J C Espín.

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Guarantor: JC Espín.

Contributors: BC: Preparation of juice; lipidogram; processing of blood and urine samples for determining polyphenols or derived metabolites; ABTS assay; ‘link’ between CEBAS-CSIC (research centre) and Virgen de La Arrixaca University Hospital. CS: Determination of respiratory function variables and physical examination of COPD patients. MDA: Collection of blood samples; isoprostane assay. PM: Processing of blood samples for determining serobiochemical and haematological parameters. FSG: Coordination and recruitment of COPD patients. FTB: Analysis of polyphenols in pomegranate juice and in vivo-generated metabolites in plasma and urine. JCE: Design of the experiment; writing of the manuscript; coordination of the trial.

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Cerdá, B., Soto, C., Albaladejo, M. et al. Pomegranate juice supplementation in chronic obstructive pulmonary disease: a 5-week randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr 60, 245–253 (2006).

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  • antioxidant
  • ellagitannin
  • ellagic acid
  • oxidative stress
  • bioavailability
  • microflora

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