Bergamot Reduces Plasma Lipids and Reduces Markers of Atherosclerosis in Individuals with Hypercholesterolemia

by | May 17, 2021 | 2016, Blood Lipids, Botanicals, Cardiovascular Health

Written by Angeline A. De Leon, Staff Writer. Six months of supplementation with Bergavit® was shown to significantly improve not only plasma lipid levels in subjects with moderate hypercholesterolemia, but lipoprotein profile as well.

BergamotIn patients with high serum cholesterol levels, statins are commonly employed to help lower plasma lipids and lipoproteins 1. However, the use of such lipid-lowering medications is not entirely effective nor well-tolerated by all patients 2,3. Alternative treatments for dyslipidemia are becoming increasingly popular 4, with nutraceuticals like citrus flavonoids becoming more readily utilized for their cardioprotective effects 5. More specifically, the fragrant citrus fruit Citrus bergamia Risso, also known as Bergamot, has demonstrated significant cholesterol-lowering effects 6, attributed to its abundance of flavonoid glycosides 7. By inhibiting the oxidation of LDL and decreasing oxidative stress levels, flavonoids exert an anti-atherosclerotic effect 8. Bergamot’s high content and unique composition of flavonoids make it a promising nutraceutical treatment for dyslipidemia, and as evidenced in previous research, supplementation can effectively reduce LDL-C levels in individuals with metabolic dysfunction 9. To further test the cardiometabolic benefits associated with Bergamot, a 2016 study 10 published in Frontiers in Pharmacology evaluated the effects of Bergamot extract on plasma lipids and lipoprotein profile in subjects with hypercholesterolemia.

A total of 80 patients (mean age = 55 +/- 13 years) with moderate hypercholesterolemia (plasma LDL-C concentrations between 160 and 190 mg/dl) were enrolled in a 6-month prospective clinical intervention trial. All subjects consumed a proprietary blend of Bergamot-derived flavonoid extract (Bergavit®) containing 150 mg of flavonoids daily for 6 months. At baseline and at 6-month follow-up, serum blood samples were collected for analysis of total cholesterol (TC), triglycerides (TG), LDL-C, and high-density lipoprotein cholesterol (HDL-C). Gel electrophoresis was used to assess 11 distinct lipoprotein subclasses, including 7 atherogenic LDL subfractions. Color doppler ultrasound was also performed to examine subclinical atherosclerosis based on the arterial wall thickness of the carotid arteries (carotid intima-media thickness, cIMT).

After 6 months of supplementation with Bergavit®, a significant improvement in plasma lipids was apparent: a significant decrease was observed for TC (from 6.6 +/- 0.4 to 5.8 +/- 1.1 mmol/l, p < 0.0001), LDL-C (from 4.6 +/- 0.2 to 3.7 +/- 1.0 mmol/l, p < 0.0001), and TG (from 1.8 +/- 0.6 to 1.5 +/- 0.9 mmol/l, p = 0.0020), while HDL-C was seen to increase (from 1.3 +/- 0.2 to 1.4 +/- 0.4 mmol/l, p < 0.0007). In addition, from baseline to 6-month follow-up, large LDL1 particles were found to increase by 20% (p < 0.0001), whereas significant reductions were seen for small, dense LDL3 (by 38%, p < 0.0001), LDL4 (by 53%, p = 0.0053), and LDL5 (by 67%, p = 0.0133) particles. Finally, 6 months of Bergamot supplementation was associated with a significant 25% reduction in cIMT (from 1.2 +/- 0.4 to 0.9 +/- 0.1 mm, p < 0.0001).

Six months of supplementation with Bergavit® was proven to significantly improve not only plasma lipid levels in subjects with moderate hypercholesterolemia, but lipoprotein profile (plasma lipoprotein subfractions) as well. The current study also provides the first known evidence for an association between Bergamot supplementation and reduced cIMT, indicative of lowered subclinical atherosclerosis. Overall, the present study suggests that Bergamot has the potential to improve both the quality and quantity of LDL-C in individuals with high cholesterol, making it a desirable alternative treatment for dyslipidemic subjects. Additional research is needed to explore the underlying mechanisms responsible for Bergamot’s lipid-lowering effects. It would also be vital to replicate findings using a randomized, double-blind, placebo-controlled study design in the future.

Source: Toth PP, Patti AM, Nikolic D, et al. Bergamot reduces plasma lipids, atherogenic small dense LDL, and subclinical atherosclerosis in subjects with moderate hypercholesterolemia: a 6-month prospective study. Frontiers in Pharmacology. 2016; 6: 299. DOI: 10.3389/fphar.2015.0029.

 © 2016 Toth, Patti, Nikolic, Giglio, Castellino, Biancucci, Geraci, David, Montalto, Rizvi and Rizzo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

Click here to read the full text study.

Posted May 17, 2021.

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.

References:

  1. Rizzo M, Rini GB, Berneis K. Effects of statins, fibrates, rosuvastatin, and ezetimibe beyond cholesterol: the modulation of LDL size and subclasses in high-risk patients. Adv Ther. 2007;24(3):575-582.
  2. Alagona P, Jr., Ahmad TA. Cardiovascular disease risk assessment and prevention: current guidelines and limitations. The Medical clinics of North America. 2015;99(4):711-731.
  3. Banach M, Rizzo M, Toth PP, et al. Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel. Archives of medical science : AMS. 2015;11(1):1-23.
  4. Patti AM, Katsiki N, Nikolic D, Al-Rasadi K, Rizzo M. Nutraceuticals in lipid-lowering treatment: a narrative review on the role of chitosan. Angiology. 2015;66(5):416-421.
  5. Benavente-García O, Castillo J. Update on uses and properties of citrus flavonoids: new findings in anticancer, cardiovascular, and anti-inflammatory activity. J Agric Food Chem. 2008;56(15):6185-6205.
  6. Di Donna L, Iacopetta D, Cappello AR, et al. Hypocholesterolaemic activity of 3-hydroxy-3-methyl-glutaryl flavanones enriched fraction from bergamot fruit (Citrus bergamia):“In vivo” studies. Journal of functional foods. 2014;7:558-568.
  7. Choe S-C, Kim H-S, Jeong T-S, Bok S-H, Park Y-B. Naringin has an antiatherogenic effect with the inhibition of intercellular adhesion molecule-1 in hypercholesterolemic rabbits. Journal of cardiovascular pharmacology. 2001;38(6):947-955.
  8. Kumar A, Chambers TC, Cloud-Heflin BA, Mehta KD. Phorbol ester-induced low density lipoprotein receptor gene expression in HepG2 cells involves protein kinase C-mediated p42/44 MAP kinase activation. J Lipid Res. 1997;38(11):2240-2248.
  9. Gliozzi M, Carresi C, Musolino V, et al. The effect of bergamot-derived polyphenolic fraction on LDL small dense particles and non alcoholic fatty liver disease in patients with metabolic syndrome. Advances in Biological Chemistry. 2014;4(02):129.
  10. Toth PP, Patti AM, Nikolic D, et al. Bergamot Reduces Plasma Lipids, Atherogenic Small Dense LDL, and Subclinical Atherosclerosis in Subjects with Moderate Hypercholesterolemia: A 6 Months Prospective Study. Front Pharmacol. 2015;6:299.