Pomegranate: “A Pharmacy unto Itself” – Smooth Sailing for Blood Vessels

The slippery, garnet-red seeds of the pomegranate (dried and used in India as a spice) started to attain notoriety as a gourmet health food back in the ‘90s, when studies first linked them to heart and prostate health. These days, pomegranate is mega-trendy, and you can find it flavoring everything from water to popsicles to cocktails. It is also mega-healthy. Every bit of it. The seeds, pulp, skin, root, flower—even the bark from the pomegranate tree—are all brimming with polyphenols, disease-fighting antioxidants found in plants. (Pomegranate seed extracts and juice have two to three times the antioxidant activity of red wine and green tea, those antioxidant superstars.)

But while many foods and spices are rich in polyphenols, pomegranate is one of the few that is a top source of several varieties—flavonoids, anthocyanins, ellagic acid, punicic acid, and many others. Hundreds of scientific studies confirm that this natural pharmacy of polyphenols may help prevent or treat a variety of diseases, including the three leading killers of Americans: heart disease, cancer, and stroke.

Those scientific findings wouldn’t surprise an Ayurvedic physician using India’s ancient system of natural healing—an Ayurvedic text calls the pomegranate “a pharmacy unto itself.”

Smooth Sailing for Blood Vessels

Heart attacks and strokes combined kill more Americans than any other health problem. The cause: arteries leading to the heart and brain become clogged with plaque, a deadly stew of cholesterol and ruined cells, thickened by inflammation and oxidation. The medical name for this circulatory disaster: atherosclerosis. The name of a plant so powerful it can prevent and reverse the problem? Pomegranate.

Reversing arterial plaque. Israeli researchers studied 20 people with atherosclerosis in the carotid artery—the artery in the neck that supplies blood to the brain. (A blockage in this artery produces a stroke.) Ten drank pomegranate juice and 10 didn’t. After one year, those drinking the juice had a 30 percent decrease in arterial plaque, while those not drinking the juice had a 9 percent increase. The results were reported in Clinical Nutrition.

Researchers at the University of Chicago studied 189 people (ages 45 to 74) with one or more risk factors for heart disease, such as high cholesterol and high blood pressure. They divided them into two groups: one group drank eight ounces of pomegranate juice a day and the other didn’t. After one year, those in the study with the highest risk for heart disease—with the highest total cholesterol, highest LDL cholesterol, highest triglycerides, and highest level of several other risk factors—had a much slower growth rate of arterial plaque if they were in the group drinking pomegranate juice. The findings were in the American Journal of Cardiology.

Reviving damaged hearts. Doctors from the University of California, San Francisco (UCSF) studied 45 people (average age, 69) with heart disease. Nearly half had suffered heart attacks, most had high blood pressure, and nearly all had high cholesterol. They were all taking several drugs to battle heart disease, including cholesterol-lowering statins, blood thinners, and blood pressure drugs.

The researchers divided them into two groups. For three months, one group drank eight ounces a day of pomegranate juice, while the other group drank a placebo juice.

At the beginning and end of the three months, the doctors gave both groups a myocardial perfusion test—a type of “stress test” that uses a CAT scan to measure blood flow (ischemia) to the heart during exercise.

After three months, the group drinking pomegranate juice had a 17 percent increase in blood flow to the heart, while the placebo group had a decrease of 18 percent.

And those are important test results: a study shows that the best predictor of whether or not a person with heart disease will have a heart attack is the amount of blood flow to the heart as measured by a myocardial perfusion test!

Less angina. The UCSF researchers also found that episodes of angina (intense chest pain) decreased by 50 percent in the pomegranate group, while increasing by 38 percent in the non-pomegranate group.

The findings were reported in the American Journal of Cardiology.

Increasing nitric oxide. The delicate lining of the arteries is called the endothelium. There, a thin layer of endothelial cells pump out nitric oxide (NO), a compound that fights oxidation and inflammation, keeping arteries flexible and young. Some experts think that a low level of nitric oxide is the primary cause of atherosclerosis.

Researchers from the University of Naples in Italy and UCLA conducted several studies testing the effect of pomegranate on nitric oxide. They found:

• Pomegranate juice was far more potent than Concord grape juice, blueberry juice, red wine, vitamin C, and vitamin E (all powerful antioxidants) at protecting nitric oxide against oxidative destruction. “Pomegranate juice possesses potent antioxidant activity that results in marked protection of NO against oxidative destruction,” concluded the researchers in the journal Nitric Oxide.

• In the laboratory, pomegranate juice decreased the activity of genes that make endothelial cells more prone to oxidation, and it increased the production of an enzyme (endothelial NO synthase) that plays a key role in NO production. Pomegranate, the researchers concluded in the Proceedings of the National Academy of Sciences, may have a role in the “prevention and treatment of atherosclerosis.”

Lowering high blood pressure. Israeli researchers asked people with high blood pressure to drink a small amount of pomegranate juice every day. After two weeks, they had a 5 percent drop in systolic blood pressure (the upper reading). They also had a 31 percent decrease in the activity of the enzyme (angiotensin-converting enzyme, or ACE) targeted by the pressure-lowering, ACE-inhibiting medications. “Pomegranate juice can offer…protection” against cardiovascular disease, they concluded in the journal Atherosclerosis.

Circulatory Protection for Diabetes

Diabetes, a blood sugar disorder, also damages blood vessels—75 percent of people with diabetes die from atherosclerosis. And almost all the so-called “complications” of diabetes (which are more like diseases themselves) are caused by circulatory problems—blindness from damaged circulation to the retina of the eye, kidney failure from damage to blood vessels in kidneys, the burning and numbness of nerve problems from reduced blood flow to nerves, amputations (diabetes is the most common cause of non-trauma amputations) from poor circulation to the legs and feet. Pomegranate can protect blood vessels in people with diabetes.

Protecting HDL from oxidation. “Good” HDL cholesterol decreases artery-clogging plaque. Israeli researchers gave 10 people with diabetes either pomegranate juice or pomegranate extract. After one month, there was a 40 percent increase in enzymes that protect HDL from oxidation. “These beneficial effects . . . could lead to retardation of atherosclerosis development in diabetic patients,” concluded the researchers in the Journal of Agricultural and Food Chemistry.

Lowering cholesterol. Researchers in Iran gave concentrated pomegranate juice to 22 people with diabetes. After one month, they saw significant decreases in total cholesterol and LDL cholesterol. Pomegranate consumption “could modify heart disease risk factors” in people with diabetes, wrote the researchers in the International Journal of Vitamin and Nutrition Research.

Stopping oxidation in arteries. Another team of Israeli researchers gave pomegranate juice for three months to 10 people with diabetes, measuring levels of oxidation in their bloodstream. The level of oxidized blood fats was decreased 58 percent and the overall level of cellular oxidation was decreased by 71 percent. “Pomegranate juice consumption . . . could contribute to attenuation of atherosclerosis” in people with diabetes, they concluded in the journal Atherosclerosis.

Controlling diabetes. And in animal studies from the US, Australia, and India, pomegranate (pomegranate flower and pomegranate seed oil) controlled or reversed diabetes itself.

Stopping Incurable Prostate Cancer

Prostate cancer kills more men than any other cancer, except for lung. In the last five years, there’s been an explosion of research showing that pomegranate can battle the disease.

First, researchers in Germany and at the University of Wisconsin found that pomegranate extracts could stop prostate cancer cells from growing and then kill them, and also prevent prostate cancer from growing and spreading in experimental animals. “Pomegranate consumption may retard prostate cancer progression, which may prolong the survival and quality of life” of prostate cancer patients, concluded the US researchers in the journal Cell Cycle.

Then, researchers at UCLA gave eight ounces of pomegranate juice a day to men with prostate cancer who had been treated with either radiation or surgery (removal of the prostate, or radical prostatectomy) but still had rising levels of prostate-specific antigen (PSA), a biomarker of tumor growth.

Before the treatment, the men’s average PSA “doubling time” (for example, the time it takes for PSA to rise from 2 to 4) was 15 months. After the treatment, it was 54 months!

Other tests showed a 12 percent decrease in the growth of cancer cells, a 17 percent increase in the death of cancer cells, and a 23 percent increase in blood levels of nitric oxide (which battles cancer).

“There are limited treatment options for prostate cancer patients who have undergone primary therapy such as radical prostatectomy but have progressive elevation of their PSA,” wrote David Heber, MD, one of the study researchers, in the journal Cancer Letters. “Our data on pomegranate juice given daily for two years to 40 prostate cancer patients with rising PSA provides a non-toxic option for prevention or delay of prostate carcinogenesis. It is remarkable that 85 percent of patients responded to pomegranate juice in this study.”

Since their study, the UCLA researchers have conducted several more, with the goal of discovering the main mechanism whereby pomegranate beats cancer. Their conclusion: it blocks the activity ofnuclear factor-kappa B, a protein complex found in the nucleus of cells that fuels prostate cancer.

Test tube and animal studies show pomegranate may fight other types of cancer. A few examples of the more than 80 studies on pomegranate and cancer:

Breast cancer. Pomegranate reduced the growth of human breast cancer cells in test animals by up to 87 percent, in a study reported in Breast Cancer Research and Treatment.

Colon cancer. An extract of pomegranate seed oil cut colon cancer rates by 44 percent in experimental animals, reported Japanese researchers in Cancer Science.

Lung cancer. Pomegranate extract reduced lung cancer by 61 percent in experimental animals, in a study in Cancer Research.

Skin cancer. Pomegranate used as a topical lotion significantly decreased tumors and inhibited skin cancer from spreading in animals, in a study in International Journal of Cancer.

Leukemia. Pomegranate extract stopped the growth of leukemia cells, in test tube research from Japan, reported in the Journal of Medicinal Food.

The Promise of Pomegranate

Pomegranate shows promise in preventing and treating several other conditions.

Dental problems. Brazilian researchers studied 60 people and found that rinsing the mouth with an extract containing pomegranate reduced bacteria-causing dental plaque 84 percent more than a commercial mouthwash.

When researchers in Thailand treated gum disease (periodontal disease) with pomegranate extract, they found it decreased gum erosion and plaque.

And a pomegranate formula helped clear up denture stomatitis, a fungal infection in people wearing dentures.

Erectile dysfunction. A study at the Male Clinic in Beverly Hills found that men who drank pomegranate juice for two weeks had improvements in erectile difficulties. The results were reported in theInternational Journal of Impotence Research.

Wrinkles and aging skin. Women who took pomegranate extract daily for four weeks experienced less skin damage from ultraviolet radiation—the same type of damage that causes wrinkles. In another study, ellagic acid prevented collagen destruction from ultraviolet radiation. Ellagic acid “may be a promising treatment” for wrinkles, said the researchers in Experimental Dermatology.

Sports recovery. Exercisers who took a pomegranate extract recovered their strength faster after a difficult weight-lifting routine compared to exercisers who didn’t take the extract. The study was conducted by researchers at the University of Texas and appeared in Medicine &Science in Sports & Exercise.

Arthritis. In animal research, scientists from Case Western University in Cleveland, Ohio, found that a pomegranate extract slowed the development and reduced the severity (inflammation and bone destruction) of chemically induced rheumatoid arthritis. The extract “may be a useful approach for the prevention of the onset and severity of inflammatory arthritis,” concluded the researchers in Nutrition.

Researchers in Iran found that pomegranate juice protected cartilage, reducing damage from chemically induced osteoarthritis in experimental animals. Their findings were in Phytotherapy Research.

Alzheimer’s disease. Researchers from Loma Linda University in California fed experimental animals pomegranate extract from birth and found they were more alert as they aged and had 50 percent less amyloid-A in their brains, a protein linked to Alzheimer’s disease.

Overweight. Obese animals fed pomegranate extract ate less, and lost weight and fat. The results were in the International Journal of Obesity.

Male infertility. Male animals treated with pomegranate had better sperm quality (normal shape and movement), more sperm, and higher testosterone levels.

Flu. Researchers from the University of Texas Health Science Center found that pomegranate extract killed flu viruses. “Pomegranate extracts should be further studied for therapeutic and prophylactic [preventive] potential . . . for influenza epidemics and pandemics,” wrote the researchers in Phytomedicine.

Ulcerative colitis. In an animal experiment, researchers in India found that pomegranate reduced colon inflammation in this digestive disease.

Getting to Know Pomegranate

They grew in the Hanging Gardens of Babylon, one of the original “Wonders of the World.” They are celebrated in the Old Testament, and were beloved by the ancient Egyptians and Greeks. They have been a symbol of health, luck, fertility, and immortality. The city of Granada (Spanish for pomegranate) bears their name, and the fruit is featured on the city’s heraldic crest. The pomegranate, says an article inAlternative Medicine Review, is an “ancient, mystical, and highly distinctive fruit.”

So distinctive, it’s not edible! When you break it open, however, you find hundreds of deep red seeds, suspended in a jelly-like honeycomb casing, glistening like garnets. One pomegranate contains about 500 seeds. They don’t have much aroma, but you’ll experience a juicy, thirst-quenching, cranberry-tart and rosewater-sweet flavor when you put them in your mouth.

Pomegranates, from a 12- to 16-foot, gray-barked tree, have been a symbol of health, luck, fertility, and immortality.

Pomegranates first grew from the Himalayas of northern India to Iran, and are now cultivated throughout the Mediterranean, and also in Southeast Asia, the East Indies, and tropical Africa.

You can even find the 12- to 16-foot, gray-barked tree in Arizona and California, where they were first introduced by the Spanish in the 18th century. The fruit was slow to gain popularity in America, because it’s so daunting to remove and eat the seeds. In fact, very slow. Pomegranate first hit the market a decade or so ago, and it was considered a health fad. But now its science-proven health benefits have made it one of the superheroes of the supermarket. Yet, when it comes to the fruit itself, people still wonder: What the heck am I supposed to do with it?

(If you don’t know what you’re doing, eating the seeds can create a scene that looks like it came out of a horror movie, with the seeds leaving their blood-red color on everything they contact—your skin, your clothes, and maybe even your hair!)

In India, where pomegranate is very popular, the seeds are dried and used as a spice called anardana, which has a deliciously fruity and tangy flavor. Indians use anardana whole or ground. It is found in curries and chutneys, in fillings for savory fried snacks called pakoras, and in flatbreads called parathas. Anardana is used as a flavoring in much the same way as Indians use the green mango souring spice called amchur. Anardana is often preferred to amchur, because it delivers a sweet-and-sour rather than just a sour flavor.

In Turkey and parts of the Middle East, the fresh seeds and their juice are considered an essential flavoring to give a fruity, sweet-and-sour taste to meats and vegetables. They are used in marinades, sauces, and desserts. Dried or fresh seeds are sprinkled over salads and hummus (ground chickpeas). They are a key ingredient in the well-known Persian dish called fesenjan, a tart chicken or game stew thickened with pomegranate juice and walnuts.

Pomegranate may help prevent and/or treat:

Alzheimer’s disease

Angina

Arthritis, osteo- and

rheumatoid

Atherosclerosis

Cancer

Colitis (inflammatory bowel disease)

Denture problems

Diabetes, type 2

Erectile dysfunction

Fatigue, physical

Flu

Gum disease (periodontal disease)

High blood pressure (hypertension)

Infertility, male

Overweight

Wrinkles

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Pomegranate pairs well with these spices:

Ajowan

Allspice

Cardamom

Chile

Cinnamon

Cumin

Fennel seed

Fenugreek seed

Garlic

Ginger

Mint

Mustard seed

Onion

Turmeric

and complements recipes featuring:

Chicken

Game

Pork

Salads

Sweet desserts

Pomegranate molasses is popular in the Middle East. It’s made by crushing the seeds into juice and cooking it until it reaches an almost black, thick molasses-like texture. The molasses has a berry-like taste with a citrus tang. It is somewhat similar to grenadine—made by mixing pomegranate juice with hot sugar syrup—a non-alcoholic flavoring used in many cocktail recipes. (Today, not all “grenadine” is true grenadine.)

Pomegranate seeds are very popular in Mexican cuisine. The Mexican town of Puebla is the birthplace of chile en nogada, an elaborately made stuffed poblano chile covered in a walnut sauce and sprinkled with pomegranate seeds.

Pomegranate is also popular in Russia. Kupati is sausage made with pomegranate as well as other spices (including allspice and coriander).

In the United States, pomegranate is most widely found as juice. It is also used to flavor water, teas, energy drinks, soda, and mixed drinks. One of the most popular among today’s “fashion martinis” is the pomegranate martini—Oprah’s favorite!

How to Buy Pomegranate

The only time to enjoy fresh pomegranate seeds is when the fruit is in season, from October to January. The fruit is picked ripe and can range in size from an apple to a large orange. The largest and heaviest should give you the juiciest seeds. Look for fruit that is free of cracks and soft spots, with a bright skin color (which can vary from pink to red).

Pomegranates will stay fresh at room temperature for several weeks before drying out, but will retain their moisture better and longer in the refrigerator. They should stay fresh in the refrigerator for a month or longer. The seeds can be frozen and will keep for six to nine months. You can find fresh seeds in season, but they’re hard to come by out of season.

You can only find anardana in an Indian market or perhaps a specialty spice shop. Anardana is available dried or ground. The dried seeds are dark red with a black tinge. They will keep indefinitely. Soak them in water to soften them. Ground seeds keep for a year or longer if stored in an airtight container away from moisture and heat.

You can usually find pomegranate molasses in Middle Eastern, Armenian, or Indian markets. The molasses is easy to keep and doesn’t need refrigeration. If it gets too thick, sit the bottle in hot water for a few minutes.

In the Kitchen with Pomegranate

The inside of a pomegranate is mostly all seeds, which are layered in two chambers. The key to getting delicious seeds is to avoid the pulpy and bitter pith and connecting membranes.

The traditional way to eat pomegranate was to pick each seed from the opened fruit with a pin, but no one does it that way anymore. The easiest way to open the fruit and remove the seeds—and avoid stains—is to do it underwater at the kitchen sink. The first step is to put on an apron. Then start by placing the fruit on a paper towel. Make a single cut around the circumference using a sharp knife. Be careful not to cut deeper than the skin. Place the scored fruit in a large bowl filled with water and break it open while holding it underwater. Rub your fingers across the seeds to separate them from the yellow membrane. As they separate, the seeds will float to the top. Use a strainer to retrieve them and transfer them to a bowl.

Seeds should be ground only in a mortar and pestle, as they will clog a spice mill.

To make juice, put the seeds in a food processor or blender and process until smooth. Press the liquid through a strainer to remove the fiber.

One medium pomegranate will provide about 1 cup of seeds and ½ cup of juice.

Making pomegranate molasses is simple. Put the seeds in a pot and boil down until the seeds turn liquid and develop a thick consistency.

You can sprinkle pomegranate seeds on almost any prepared food that would benefit from sweet flavor and crunchy texture.

Here are some other ways to enjoy pomegranate seeds:

• The juice is a great tenderizer and a good addition to a marinade.

• Add a little pomegranate fruit or molasses to gravies and meat sauces as they cook.

• Before cooking, brush pomegranate molasses on chicken and pork like a marinade.

• Add a little pomegranate molasses to vinaigrette dressing.

• Put the seeds and the molasses over ice cream or frozen yogurt.

• Sprinkle seeds over salad greens or fold into fruit salads.

• Mix a little pomegranate molasses in the glass with club soda for a refreshing beverage.

• Sprinkle ground anardana on cooked vegetables or add it to soups or stews.

• Drip pomegranate molasses over beef and lamb kabobs when they are hot off the grill.

• Toss fresh seeds over lentils and other vegetarian dishes.

• To make a pomegranate martini combine 2 ounces of vodka with ½ ounce of lemon juice, ¼ ounce of pomegranate juice, and a dash of simple syrup.

Pomegranate Guacamole

A twist on this popular Mexican dip. It goes nicely with a pomegranate martini!

2 ripe avocados

1 lime

1 cup sliced scallions

4 garlic cloves, diced

2–3 serrano or jalapeño chiles, diced

¼ cup chopped cilantro

2 tablespoons pomegranate juice

¼ cup pomegranate seeds

1. Peel and pit the avocados and place them in a medium bowl. Sprinkle with the lime juice. Mash until it forms a coarse pulp.

2. Add the scallions, garlic, chiles, cilantro, and pomegranate juice. Continue to mash until well blended but still a little chunky. Fold in the pomegranate seeds.

Makes about 2 cups.