METHOD: The Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMBASE, SCOPUS and conference proceedings were searched for relevant trials to June 2019. We included randomized controlled trials comparing pomegranate with placebo. The outcomes examined were effects on lipids level. Two authors screened titles for inclusion, extracted data and assessed the quality of the trials using the revised Cochrane risk of bias tool. We used a random effects model to pool data and stratified trials to examine sources of statistical heterogeneity. To assess the quality of the evidence, we used the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.

RESULTS: Seventeen trials recruiting 763 subjects met the inclusion criteria. These trials varied in terms of the dosage form of pomegranate used, subjects recruited and trials duration. Meta-analyses of data did not show pomegranate produced a significant effect on the lipids level examined. The quality of evidence for all outcomes was low due to the imprecision of the pooled effect and the inconsistency within the included trials. The limited data on safety suggest only mild, transient and infrequent adverse events with the short-term use of pomegranate.

METHODS: Included trials were assessed using Cochrane risk of bias instrument. We performed meta-analysis with random-effects model and random errors were evaluated with TSA. We performed the search for the eligible randomized controlled trial (RCT) through Medline, Cinahl, Cochrane Central Register of Controlled Trials and also PubMed.