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Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis

      Highlights

      • Consuming tomato and tomato products is associated with potential beneficial effects to health.
      • Current evidence indicates that consuming tomato improves some blood lipids, blood pressure and endothelial function.
      • Tomato consumption may potentially reduce the risk of cardiovascular diseases and mortality.
      • The effects of consuming tomato on novel biomarkers of vascular risk needs further investigation.

      Abstract

      Background and aims

      Epidemiological evidence suggests an association between consumption of tomato products or lycopene and lower risk for cardiovascular diseases (CVD). Our aim was to evaluate the state of the evidence from intervention trials on the effect of consuming tomato products and lycopene on markers of cardiovascular (CV) function. We undertook a systematic review and meta-analysis on the effect of supplementing tomato and lycopene on CV risk factors.

      Methods

      Three databases including Medline, Web of science, and Scopus were searched from inception to August 2016. Inclusion criteria were: intervention trials reporting effects of tomato products and lycopene supplementation on CV risk factors among adult subjects >18 years of age. The outcomes of interest included blood lipids (total-, HDL-, LDL-cholesterol, triglycerides, oxidised-LDL), endothelial function (flow-mediated dilation (FMD), pulse wave velocity (PWV)) and blood pressure (BP) inflammatory factors (CRP, IL-6) and adhesion molecules (ICAM-1). Random-effects models were used to determine the pooled effect sizes.

      Results

      Out of 1189 publications identified, 21 fulfilled inclusion criteria and were meta-analysed. Overall, interventions supplementing tomato were associated with significant reductions in LDL-cholesterol (−0.22 mmol/L; p = 0.006), IL-6 (standardised mean difference −0.25; p = 0.03), and improvements in FMD (2.53%; p = 0.01); while lycopene supplementation reduced systolic-BP (−5.66 mmHg; p = 0.002). No other outcome was significantly affected by these interventions.

      Conclusions

      The available evidence on the effects of tomato products and lycopene supplementation on CV risk factors supports the view that increasing the intake of these has positive effects on blood lipids, blood pressure and endothelial function. These results support the development of promising individualised nutritional strategies involving tomatoes to tackle CVD.

      Keywords

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      References

        • Forouzanfar M.H.
        • Alexander L.
        • Anderson H.R.
        • Bachman V.F.
        • Biryukov S.
        • Brauer M.
        • Burnett R.
        • Casey D.
        • Coates M.M.
        • Cohen A.
        • et al.
        Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
        Lancet. 2015; 386: 2287-2323
        • Mozaffarian D.
        • Appel L.J.
        • Van Horn L.
        Components of a cardioprotective diet: New insights.
        Circulation. 2011; 123: 2870-2891
        • Siervo M.
        • Lara J.
        • Ogbonmwan I.
        • Mathers J.C.
        Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis.
        J. Nutr. 2013; 143: 818-826
        • Lara J.
        • Ashor A.W.
        • Oggioni C.
        • Ahluwalia A.
        • Mathers J.C.
        • Siervo M.
        Effects of inorganic nitrate and beetroot supplementation on endothelial function: a systematic review and meta-analysis.
        Eur. J. Nutr. 2016; 55: 451-459
        • Sesso H.D.
        • Liu S.
        • Gaziano J.M.
        • Buring J.E.
        Dietary lycopene, tomato-based food products and cardiovascular disease in women.
        J. Nutr. 2003; 133: 2336-2341
        • Jacques P.F.
        • Lyass A.
        • Massaro J.M.
        • Vasan R.S.
        • D'Agostino Sr., R.B.
        Relationship of lycopene intake and consumption of tomato products to incident CVD.
        Br. J. Nutr. 2013; 110: 545-551
        • Mein J.R.
        • Lian F.
        • Wang X.D.
        Biological activity of lycopene metabolites: implications for cancer prevention.
        Nutr. Rev. 2008; 66: 667-683
        • Higgins J.
        • Green S.
        Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011].
        (Cochrane Database Syst Rev)2011
        • University of York
        Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care.
        (York, UK)2009
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        Int. J. Surg. 2010; 8: 336-341
        • Egger M.
        • Davey Smith G.
        • Schneider M.
        Minder C: bias in meta-analysis detected by a simple, graphical test.
        Bmj. 1997; 315: 629-634
        • Jadad A.R.
        • Moore R.A.
        • Carroll D.
        • Jenkinson C.
        • Reynolds D.J.M.
        • Gavaghan D.J.
        • McQuay H.J.
        Assessing the quality of reports of randomized clinical trials: is blinding necessary?.
        Control Clin. Trials. 1996; 17: 1-12
        • Biddle M.J.
        • Lennie T.A.
        • Bricker G.V.
        • Kopec R.E.
        • Schwartz S.J.
        • Moser D.K.
        Lycopene dietary intervention: a pilot study in patients with heart failure.
        J. Cardiovasc. Nurs. 2015; 30: 205-212
        • Blum A.
        • Merei M.
        • Karem A.
        • Blum N.
        • Ben-Arzi S.
        • Wirsansky I.
        • Khazim K.
        Effects of tomatoes on the lipid profile.
        Clin. Invest Med. 2006; 29: 298-300
        • Blum A.
        • Monir M.
        • Khazim K.
        • Peleg A.
        • Blum N.
        Tomato-rich (Mediterranean) diet does not modify inflammatory markers.
        Clin. Investig. Med. Méd. Clin. Exp. 2007; 30: E70-E74
        • Burton-Freeman B.
        • Talbot J.
        • Park E.
        • Krishnankutty S.
        • Edirisinghe I.
        Protective activity of processed tomato products on postprandial oxidation and inflammation: a clinical trial in healthy weight men and women.
        Mol. Nutr. Food Res. 2012; 56: 622-631
        • Collins J.K.
        • Arjmandi B.H.
        • Claypool P.L.
        • Perkins-Veazie P.
        • Baker R.A.
        • Clevidence B.A.
        Lycopene from two food sources does not affect antioxidant or cholesterol status of middle-aged adults.
        Nutr. J. 2004; 3: 15
        • Cuevas-Ramos D.
        • Almeda-Valdés P.
        • Chávez-Manzanera E.
        • Meza-Arana C.E.
        • Brito-Córdova G.
        • Mehta R.
        • Pérez-Méndez O.
        • Gómez-Pérez F.J.
        Effect of tomato consumption on high-density lipoprotein cholesterol level: a randomized, single-blinded, controlled clinical trial.
        Diabetes Metab. Syndr. Obes. 2013; 6: 263-273
        • Devaraj S.
        • Mathur S.
        • Basu A.
        • Aung H.H.
        • Vasu V.T.
        • Meyers S.
        • Jialal I.
        A dose-response study on the effects of purified lycopene supplementation on biomarkers of oxidative stress.
        J. Am. Coll. Nutr. 2008; 27: 267-273
        • Engelhard Y.N.
        • Gazer B.
        • Paran E.
        Natural antioxidants from tomato extract reduce blood pressure in patients with grade-1 hypertension: a double-blind, placebo-controlled pilot study.
        Am. Heart J. 2006; 151 (e101-100.e106): 100
        • Gajendragadkar P.R.
        • Hubsch A.
        • Maeki-Petaejae K.M.
        • Serg M.
        • Wilkinson I.B.
        • Cheriyan J.
        Effects of oral lycopene supplementation on vascular function in patients with cardiovascular disease and healthy volunteers: a randomised controlled trial.
        Plos One. 2014; : 9
        • Ghavipour M.
        • Saedisomeolia A.
        • Djalali M.
        • Sotoudeh G.
        • Eshraghyan M.R.
        • Moghadam A.M.
        • Wood L.G.
        Tomato juice consumption reduces systemic inflammation in overweight and obese females.
        Br. J. Nutr. 2013; 109: 2031-2035
        • Kim J.Y.
        • Paik J.K.
        • Kim O.Y.
        • Park H.W.
        • Lee J.H.
        • Jang Y.
        • Lee J.H.
        Effects of lycopene supplementation on oxidative stress and markers of endothelial function in healthy men.
        Atherosclerosis. 2011; 215: 189-195
        • Markovits N.
        • Ben Amotz A.
        • Levy Y.
        The effect of tomato-derived lycopene on low carotenoids and enhanced systemic inflammation and oxidation in severe obesity.
        Isr. Med. Assoc. J. 2009; 11: 598-601
        • Misra R.
        • Mangi S.
        • Joshi S.
        • Mittal S.
        • Gupta S.K.
        • Pandey R.M.
        LycoRed as an alternative to hormone replacement therapy in lowering serum lipids and oxidative stress markers: a randomized controlled clinical trial.
        J. Obstet. Gynaecol. Res. 2006; 32: 299-304
        • Paran E.
        • Novack V.
        • Engelhard Y.N.
        • Hazan-Halevy I.
        The effects of natural antioxidants from tomato extract in treated but uncontrolled hypertensive patients.
        Cardiovasc Drugs Ther. 2009; 23: 145-151
        • Ried K.
        • Frank O.R.
        • Stocks N.P.
        Dark chocolate or tomato extract for prehypertension: a randomised controlled trial.
        BMC Complement. Altern. Med. 2009; 9: 22
        • Samaras A.
        • Tsarouhas K.
        • Paschalidis E.
        • Giamouzis G.
        • Triposkiadis F.
        • Tsitsimpikou C.
        • Becker A.T.
        • Goutzourelas N.
        • Kouretas D.
        Effect of a special carbohydrate-protein bar and tomato juice supplementation on oxidative stress markers and vascular endothelial dynamics in ultra-marathon runners.
        Food Chem. Toxicol. 2014; 69: 231-236
        • Silaste M.L.
        • Alfthan G.
        • Aro A.
        • Kesaniemi Y.A.
        • Horkko S.
        Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation.
        Br. J. Nutr. 2007; 98: 1251-1258
        • Stangl V.
        • Kuhn C.
        • Hentschel S.
        • Jochmann N.
        • Jacob C.
        • Böhm V.
        • Fröhlich K.
        • Müller L.
        • Gericke C.
        • Lorenz M.
        Lack of effects of tomato products on endothelial function in human subjects: results of a randomised, placebo-controlled cross-over study.
        Br. J. Nutr. 2011; 105: 263-267
        • Thies F.
        • Masson L.F.
        • Rudd A.
        • Vaughan N.
        • Tsang C.
        • Brittenden J.
        • Simpson W.G.
        • Duthie S.
        • Horgan G.W.
        • Duthie G.
        Effect of a tomato-rich diet on markers of cardiovascular disease risk in moderately overweight, disease-free, middle-aged adults: a randomized controlled trial.
        Am. J. Clin. Nutr. 2012; 95: 1013-1022
        • Tsitsimpikou C.
        • Tsarouhas K.
        • Kioukia-Fougia N.
        • Skondra C.
        • Fragkiadaki P.
        • Papalexis P.
        • Stamatopoulos P.
        • Kaplanis I.
        • Hayes A.W.
        • Tsatsakis A.
        • et al.
        Dietary supplementation with tomato-juice in patients with metabolic syndrome: a suggestion to alleviate detrimental clinical factors.
        Food Chem. Toxicol. 2014; 74: 9-13
        • Upritchard J.E.
        • Sutherland W.H.F.
        • Mann J.I.
        Effect of supplementation with tomato juice, vitamin E, and vitamin C on LDL oxidation and products of inflammatory activity in type 2 diabetes.
        Diabetes Care. 2000; 23: 733-738
        • Xaplanteris P.
        • Vlachopoulos C.
        • Pietri P.
        • Terentes-Printzios D.
        • Kardara D.
        • Alexopoulos N.
        • Aznaouridis K.
        • Miliou A.
        • Stefanadis C.
        Tomato paste supplementation improves endothelial dynamics and reduces plasma total oxidative status in healthy subjects.
        Nutr. Res. (New York, NY). 2012; 32: 390-394
        • Ried K.
        • Fakler P.
        Protective effect of lycopene on serum cholesterol and blood pressure: meta-analyses of intervention trials.
        Maturitas. 2011; 68: 299-310
        • Li X.
        • Xu J.
        Lycopene supplement and blood pressure: an updated meta-analysis of intervention trials.
        Nutrients. 2013; 5: 3696-3712
        • Gonzalez M.A.
        • Selwyn A.P.
        Endothelial function, inflammation, and prognosis in cardiovascular disease.
        Am. J. Med. 2003; 115: 99s-106s
        • Ashor A.W.
        • Siervo M.
        • van der Velde F.
        • Willis N.D.
        • Mathers J.C.
        Systematic review and meta-analysis of randomised controlled trials testing the effects of vitamin C supplementation on blood lipids.
        Clin. Nutr. 2016; 35: 626-637
        • Chen J.
        • Song Y.
        • Zhang L.
        Effect of lycopene supplementation on oxidative stress: an exploratory systematic review and meta-analysis of randomized controlled trials.
        J. Med. food. 2013; 16: 361-374
        • Chobanian A.V.
        • Bakris G.L.
        • Black H.R.
        • Cushman W.C.
        • Green L.A.
        • Izzo Jr., J.L.
        • Jones D.W.
        • Materson B.J.
        • Oparil S.
        • Wright Jr., J.T.
        • et al.
        Seventh report of the Joint national committee on prevention, detection, evaluation, and treatment of high blood pressure.
        Hypertension. 2003; 42: 1206-1252
        • Reboldi G.
        • Gentile G.
        • Angeli F.
        • Ambrosio G.
        • Mancia G.
        • Verdecchia P.
        Effects of intensive blood pressure reduction on myocardial infarction and stroke in diabetes: a meta-analysis in 73,913 patients.
        J. Hypertens. 2011; 29: 1253-1269
        • Baigent C.
        • Keech A.
        • Kearney P.M.
        • Blackwell L.
        • Buck G.
        • Pollicino C.
        • Kirby A.
        • Sourjina T.
        • Peto R.
        • Collins R.
        • et al.
        Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins.
        Lancet. 2005; 366: 1267-1278
        • Inaba Y.
        • Chen J.A.
        • Bergmann S.R.
        Prediction of future cardiovascular outcomes by flow-mediated vasodilatation of brachial artery: a meta-analysis.
        Int. J. Cardiovasc Imaging. 2010; 26: 631-640
        • Xu Y.
        • Arora R.C.
        • Hiebert B.M.
        • Lerner B.
        • Szwajcer A.
        • McDonald K.
        • Rigatto C.
        • Komenda P.
        • Sood M.M.
        • Tangri N.
        Non-invasive endothelial function testing and the risk of adverse outcomes: a systematic review and meta-analysis.
        Eur. Heart J. Cardiovasc Imaging. 2014; 15: 736-746
        • Matsuzawa Y.
        • Kwon T.G.
        • Lennon R.J.
        • Lerman L.O.
        • Lerman A.
        Prognostic value of flow-mediated vasodilation in brachial artery and fingertip artery for cardiovascular events: a systematic review and meta-analysis.
        J. Am. Heart Assoc. 2015; : 4