Amla Fruit Extract Improves Cardiovascular Risk Factors in Patients with Metabolic Syndrome

by | Jul 15, 2019 | 2019, Fruits and Vegetables, Metabolic Syndrome, Polyphenols

Written by Angeline A. De Leon, Staff Writer. Phyllanthus emblica (amla fruit), at a 500 mg daily dose, significantly improved components of metabolic syndrome such as endothelial function, oxidative stress biomarkers and lipid profiles in participating subjects.

obesityMetabolic syndrome (MetS) is a cluster of interrelated risk factors which increase the chances of developing heart disease, diabetes, and stroke 1. Among the conditions that fall under the category of metabolic syndrome are insulin resistance, abdominal obesity, high blood pressure, and inflammation. One of the strongest predictors of MetS is high oxidative stress and inflammation 2. Endothelial dysfunction (ED), a condition involving damage to the inner lining of blood vessels preceding development of atherosclerosis, is also a strong predictor of cardiovascular disease (CVD) and has been observed in patients with MetS 3. Phllanthus emblica, known as Indian gooseberry or amla, is a polyphenol-rich fruit extract known for its potent anti-inflammatory, anti-oxidant, and anti-diabetic properties 4. Studies on amla extract demonstrate its ability to significantly improve endothelial function and inflammation in patients with type 2 diabetes 5. In the context of ED in MetS, however, P. emblica extract has been untested. Therefore, in 2019, researchers in India conducted a trial 6 investigating the effects of standardized amla extract on ED, oxidative stress, and lipid profile in subjects with MetS.

In a prospective, randomized, double-blind, placebo-controlled clinical trial, a total of 59 subjects (aged 30 to 68 years) with ED and MetS were enrolled.  Participants were randomized to receive an aqueous extract of P. emblica 250 mg, P. emblica 500 mg, or placebo twice daily for 12 weeks. At week 4, week 8, and week 12, endothelial function was assessed based on changes in reflection index (RI) on the salbutamol challenge test. At baseline and week 12, fasting blood samples were collected and analyzed for nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH), high-sensitivity C-reactive protein (hsCRP), and lipid profile.

Treatment with amla extract at both dosage levels produced significant reduction in mean RI, compared to placebo, at week 8 and week 12 (p < 0.001), indicative of improved endothelial function. The change in mean RI was found to be significantly better for P. emblica 500 mg, relative to P. emblica 250 mg (p < 0.05). At 12 weeks, significant mean percent change was observed for both the low and high doses of amla extract in NO (+41.89%, +50.7%, respectively), GSH (+24.31%, +53.22%), MDA (-21.03%, -31.44%), and hsCRP (-39.68%, 53.77%) (p < 0.001 for all). Significant mean percent change was also apparent for P. emblica 250 mg and P. emblica 500 mg in total cholesterol (TC) (-7.71%, -11.11%, respectively), high-density lipoprotein cholesterol (HDL-C) (+7.33% +22.16% p < 0.05), low-density lipoprotein cholesterol (LDL-C) (-11.39%  -21.8%), and triglycerides (TG) (-9.81% -19.22%) at the end of 12 weeks (p < 0.001 for all). Relative to the low-dose, the higher dose of amla extract was found to be more effective in improving TC (p < 0.05), LDL-C (p < 0.001), HDL-C (p < 0.001), and TG (p < 0.01).

Conclusive evidence from the study indicates the utility of P. emblica aqueous extract in improving endothelial function, inflammation and oxidative stress, and lipid profile in patients with MetS. While both doses proved to be beneficial in regards to study parameters, the higher dose of amla extract was found to be significantly more efficacious. Findings not only corroborate previous results describing the positive impact of amla extract on lipid profile and oxidative stress 7, but also contribute to a better understanding of the role of P. emblica in the context of endothelial dysfunction in MetS. In the current study, endothelial function was measured based on RI using the salbutamol challenge test. It would be beneficial for investigators to replicate results of the study using the flow-mediated vasodilation test of endothelial function, a highly-used method associated with long-term prognostic value in the clinical research field 8.

Source: Usharani P, Merugu PL, Nutalapati C. Evaluation of the effects of a standardized aqueous extract of Phyllanthus emblica fruits on endothelial dysfunction, oxidative stress, systemic inflammation, and lipid profile in subjects with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical study. BMC Complementary and Alternative Medicine. 2019; 19: 97. DOI: 10.1186/s12906-019-2509-5.

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/) (http://creativecommons.org/publicdomain/zero/1.0/)

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Posted July 15, 2019.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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