Aerobic exercise, pomegranate juice may reduce risk for type 2 diabetes

Aerobic training and daily intake of pure pomegranate juice may prevent increased liver enzymes and insulin resistance in adult men, according to findings from an Iranian study published in BMC Nutrition.

“As pomegranate juice contains many polyphenolic and flavonoid compounds, it has strong antioxidant properties and prevents oxidative stress in the body,” Sasan Nemati, of the department of exercise physiology at Razi University in Kermanshah, Iran, and colleagues wrote. “Therefore, it seems that enhancing the antioxidant system of diabetic patients following pomegranate juice intake (PJI) might help improve and prevent diabetes complications.”

In a single-blind, placebo-controlled, randomized clinical trial, Nemati and colleagues evaluated changes in anthropometric indices, insulin resistance and liver enzymes in 40 men aged 40 to 50 years with type 2 diabetes. The participants were randomly assigned to aerobic training (AT) and PJI, AT only, PJI only or no treatment for 8 weeks. The study was conducted from November 2020 to February 2021. Those assigned to AT were required to achieve 60% to 75% maximum heart rate by jogging or running for 40 minutes to 60 minutes a day, 3 days a week. Participants assigned to PJI were required to consume 240 ml of sugar or additive-free pomegranate juice daily.

Effect on body weight

The mean BMI at baseline was 34.55 kg/m² among participants in the AT plus PJI group, 32.28 kg/m² in the AT group, 32.69 kg/m² in the PJI group and 33.34 kg/m² in the control group, according to the researchers.

After 8 weeks of the intervention, the mean BMI was 32.54 kg/m² in the AT plus PJI group, 30.97 kg/m² in the AT group, 31.86 kg/m² in the PJI group and 34.22 kg/m² in the control group.

Nemati and colleagues reported significant reductions in body weight, body fat percentages and waist-hip ratios among participants in the AT plus PJI group (P = .001) as well as for participants in the AT only (P = .001 to .018) and PJI only (P = .001 to .033) groups. These variables significantly increased for participants in the control group (P = .001 to .028).

Effect on type 2 diabetes variables

There were significant improvements in fasting blood sugar, insulin and homeostasis model assessment of insulin resistant (HOMA-IR) after the interventions compared with baseline for participants in the AT plus PJI group (P = .001), the AT group (P = .001 to .024) and the PJI group (P = .001 to .043), according to the researchers. Reductions in these variables were more pronounced for participants in the AT group compared with the PJI group. However, reductions were highest for participants in the AT plus PJI group. Specifically, the average reductions in fasting blood sugar were 18 mg/dl in the AT plus PJI group, 12 in the AT group and 7.55 in the PJI group. Nemati and colleagues also reported average reductions in insulin of 0.65 U/ml in the AT plus AJI group, 0.31 U/ml in the AT group and .11 U/ml in the PJI group. For HOMA-IR, the researchers reported average reductions of 0.52 in the AT plus PJI group, 0.32 in the AT group and 0.17 in the PJI group.

There were also significant changes in aspartate transaminase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) for participants in the intervention groups after treatment compared with baseline. Similarly, participants in the AT plus PJI group experienced the most pronounced improvements, followed by participants in the AT group and then the PJI group. Participants in the AT plus PJI group achieved reductions of 11.55 U/L in AST, 9.96 U/L in ALT and 8.78 U/L in GGT. Those in the AT group achieved reductions of 5.9 U/L, 4.95 U/L and 5.21 U/L, respectively. Men in the PJI group achieved reductions of 2.37 U/L, 4.22 U/L and 4.11 U/L, respectively.

Meanwhile, participants in the control group experienced increases in all of these variables.

Overall, the findings indicate that AT plus PJI improved anthropometric indices, liver enzymes and insulin resistance among men with type 2 diabetes.

“Due to the effect of combined AT plus PJI in improving type 2 diabetes mellitus risk factors, it could be recommended to type 2 diabetes mellitus patients to prevent increased liver enzymes and insulin resistance in these,” Nemati and colleagues wrote.