Table 3.
The effects of antioxidant natural products on CVDs from clinical studies.
| Plant types | Components | Study type | Subjects | Dose and time | Outcomes | Ref. |
|---|---|---|---|---|---|---|
| Fruits | ||||||
| Guava | NA | RCT | 45 healthy students | 400 g/day, 6 weeks | Lowering BP, TC, TG, and LDL-C | [101] |
| Soursop | NA | RCT | 143 hypertensive subjects | 2 × 100 g/day, 3 months | Lowering BP | [102] |
| Orange juice | Hesperidin and naringin | Controlled nonrandomized clinical study | 10 healthy women | 300 mL/day, 2 months | Improving LDL-C, blood glucose, insulin sensitivity, and gut microbiota metabolism | [103] |
| Haskap berry | Anthocyanin | Cross-over study | 20 adults aged 62-81 years | 400 mg anthocyanins | Lowering BP and improving episodic memory | [104] |
| Cherry juice | Anthocyanin | Pilot cross-over study | 6 young and 7 old adults | 300 mL or 100 mL, 3 times | Lowering BP and heart rate | [126] |
| Pomegranate extract | Polyphenols | RCT | 55 subjects without any symptomatic disease | Containing 210 mg punicalagins, 328 mg other pomegranate polyphenols, and 0-37 mg anthocyanins, 8 weeks | Lowering SBP | [127] |
| Plum juice | Anthocyanins | Pilot cross-over dose-timing study | 12 older (65+ years) and 12 younger (18-45 years) adults | 300 mL or 100 mL, 3 times | Reducing BP and cardiovascular responses | [128] |
| Noni and chokeberry juices | NA | RCT | 88 young adults | Noni juice 30 mL; chokeberry juice 200 mL | Lowering SBP, DBP, heart rate, and blood glucose (noni juice) Slightly lowering DBP (chokeberry juice) |
[129] |
| Vegetables | ||||||
| Tomato extract | NA | RCT | 65 patients with hypertension and a high risk of CVD | 213 mg/day, 4 weeks | Lowering DBP and mean arterial pressure | [105] |
| Beetroot juice | Nitrate | Open-label cross-over study | 17 patients with chronic kidney disease | Containing 300 mg nitrate, 4 hours | Lowering peripheral BP and mean arterial pressure | [130] |
| Beetroot juice | Nitrate | Double-blind cross-over study | 20 subjects with treated yet uncontrolled hypertension | Containing 12.9 mmol nitrate, 7 days | Increasing plasma nitrite and reducing BP | [131] |
| Beetroot juice | Nitrate | Feasibility trial | 40 hypertensive pregnant women | 70 mL/day, 8 days | Lowering DBP | [106] |
| Sateria palmifolia | NA | Quasiexperiment | 10 pregnant women | NA | Lowering BP | [132] |
| Eggplant powder | NA | RCT | 100 stressed participants with normal-high BP or stage 1 hypertension | 1.2 g/day, 12 weeks | Improving BP and psychological state | [107] |
| Beetroot, rocket salad and spinach | Nitrate | Semirandomized cross-over study | 11 men and 7 women | Each group containing 800 mg nitrate | Lowering BP | [133] |
| Spices | ||||||
| Satureja hortensis L. | NA | RCT | 47 patients with metabolic syndrome | 450 mg/day, 10 weeks | Lowering TC, TG, and LDL-C and increasing HDL-C | [109] |
| Cardamom | NA | RCT | 80 overweight and obese prediabetic women | 3 g, 2 months | Lowering TC and LDL-C | [108] |
| Garlic and cumin | NA | RCT | 75 patients with T2DM | Garlic powder: 300 mg/three times a day; cumin extract: 100 mg/twice a day, 2 months | Lowering BP | [110] |
| Cinnamon, cardamom, saffron, and ginger | NA | RCT | 204 patients with T2DM | 3 g cinnamon, 3 g cardamom, 1 g saffron, and 3 g ginger in a glass of black tea, respectively, 8 weeks | All showed potent effects on controlling BP and improving endothelial function | [33] |
| Nuts | ||||||
| Almond | NA | RCT | 86 overweight or obese adults | 15% energy from almond, 12 weeks | Lowering truncal and total body fat as well as DBP | [114] |
| Walnuts | NA | RCT | 211 participants | 30 g/day, 3 months | Lowering BP | [134] |
| Walnuts | NA | RCT | 100 overweight and obese participants | 15% energy from walnut, 6 months | Reducing BW, BMI, waist circumference, SBP, TC, and LDL-C | [115] |
| Walnuts | α-Linolenic acid | RCT | 42 adults at cardiovascular risk | 57–99 g/day, 6 weeks | Regulating gut microbiota | [135] |
| Cashew nut | NA | RCT | 300 Asian Indians with T2DM | 30 g/day, 12 weeks | Decreasing SBP and increasing HDL-C | [116] |
| Cashew nut | NA | RCT | 42 adults | 42 g/day, 4 weeks | No effect on risk factors of CVD | [136] |
| Mixed nuts | NA | RCT | 48 overweight and obese adults | 250 kcal, 4 and 8 weeks | Improving BW and glucose regulation | [117] |
| Teas | ||||||
| Green tea | Catechin | RCT | 1,075 postmenopausal women | Containing 1,315 mg catechins, 6 and 12 months | Lowering TC, LDL-C, and non-HDL-C | [118] |
| Kosen-cha | Catechin | Open-label pilot study | 6 obese subjects | 5 g/L, 12 weeks | Lowering BW, BMI, waist circumferences, and serum TG levels and improving insulin resistance, vascular function, and cardiac hypertrophy | [120] |
| Goishi tea | Polyphenols | RCT | 77 subjects | Containing 122 mg of polyphenols, 12 weeks | Increasing HDL-C and lowering TG | [137] |
| Black tea | Phytosterol | RCT | Subjects with mild hypercholesterolemia | Phytosterol-enriched functional black tea, 4 weeks | Lowering TC, LDL-C, and apolipoprotein B and improving oxidative stress | [119] |
| Others | ||||||
| Hibiscus sabdariffa | NA | Cross-over study | 25 men with 1% to 10% CVD risk | 250 mL, 0, 2, and 4 h | Reducing endothelial dysfunction and CVD risk | [138] |
| Hibiscus sabdariffa | NA | RCT | 46 patients with stage 1 hypertension | 2 cup/morning, 1 month | Reducing BP | [123] |
| Chamomile | NA | RCT | 50 diabetic patients | 200 mL/day, 4 weeks | Lowering TC, LDL-C, and creatinine | [139] |
| Soy flour | NA | 3 × 3 completely randomized repeated study | 75 postmenopausal women with prediabetes and prehypertension | 25 and 45 g/day, 12 weeks | Lowering fasting plasma glucose, fasting insulin, insulin resistance, and DBP | [124] |
| Navy beans and rice bran | NA | Pilot RCT | 38 children with abnormal cholesterol | 17.5 g/day cooked navy bean powder; 15 g/day heat-stabilized rice bran; 9 g/day navy beans and 8 g/day rice bran, 4 weeks | Modulating the plasma metabolome and reducing CVD risk | [140] |
| Oat noodles | NA | RCT | 84 healthy and mild hypercholesterolemic subjects | 100 g/day (replacing 1 or 2 meals of staple food), 10 weeks | Reducing TC/HDL-C and LDL-C/HDL-C ratios and blood pressure | [125] |
| Green coffee bean | NA | RCT | Patients with the metabolic syndrome | 400 mg twice/day, 8 weeks | Reducing SBP, insulin resistance, and abdominal obesity and inhibiting appetite | [141] |
Note. NA: not available; RCT: randomized controlled trial; CVD: cardiovascular disease; T2DM: type 2 diabetes mellitus; BW: body weight; BMI: body mass index; BP: blood pressure; SBP: systolic blood pressure; DBP: diastolic blood pressure; TC: total cholesterol; TG: triglyceride; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol.