Reviewed: Tasic N, Jakovlijevic VLJ, Mitrovic M, et al. Black chokeberry Aronia melanocarpa extract reduces blood pressure, glycemia and lipid profile in patients with metabolic syndrome: A prospective controlled trial. Mol Cell Biochem. July 2021;476(7):2663-2673. doi: 10.1007/s11010-021-04106-4.

Metabolic syndrome (MetS) is a disorder characterized by symptoms such as high blood pressure and elevated cholesterol and triglyceride levels that increase the risk of heart disease, diabetes, and stroke. Fruits like aronia berry (Aronia melanocarpa, Rosaceae), also known as black chokeberry, are rich in antioxidants and phytonutrients such as anthocyanins (a bioactive flavonoid), which have been shown in clinical trials to improve some symptoms of MetS. Still, few studies have assessed the effects of aronia berry in the prevention and treatment of MetS. This prospective, open-label, clinical case-series trial aimed to examine the effects of a standardized aronia berry extract (SAE) on clinical and biochemical parameters in people with MetS.

The study was conducted from February 2018 to November 2019. People who were 35-70 years old with MetS were eligible for inclusion. The authors excluded people with type 1 diabetes mellitus, malignant tumors, a history of any severe disease that could hinder the investigation, or a hypersensitivity to the intervention. People who currently consumed dietary supplements, were pregnant or lactating, or excessively used alcohol also were excluded.

Participants were stratified into four groups based on gender and whether they had type 2 diabetes mellitus (T2DM): men with MetS (n = 42), women with MetS (n = 42), men with MetS and T2DM (n = 28), and women with MetS and T2DM (n = 32). Anthropometric, hemodynamic (e.g., blood pressure and heart rate), and biochemical data were collected at baseline and after two and four weeks of SAE treatment. All significant changes were reported as P < 0.05.

All participants received 30 mL of an SAE (A-LIXIR® 400 Protect; Pharmanova; Belgrade, Serbia) before or during dinner for four weeks. This SAE is an oral solution that is rich in polyphenols (431 mg/30 mL), anthocyanins (120 mg/30 mL), and potassium sorbate (35.1 mg/30 mL) and has a low content of ethanol (0.04% by volume), according to the authors.

A total of 143 participants who were 50-60 years old completed the trial. (One participant apparently did not complete the trial, but no additional information was provided in the paper.) There was no significant difference in age among the groups.

Body weight significantly decreased in men with T2DM after two weeks of SAE treatment, and in all groups after four weeks compared with baseline. Waist size significantly decreased in women without T2DM after two weeks of treatment, and in all groups after four weeks compared with baseline. After two and four weeks of treatment, systolic and diastolic blood pressure significantly decreased with no significant changes in heart rate in all groups. Low-density lipoprotein cholesterol (LDL-C) was significantly reduced in women with T2DM after two weeks of treatment, and in all groups after four weeks. After four weeks of SAE treatment, total cholesterol and LDL-C were significantly reduced in all groups, and triglycerides were significantly reduced in men and women with T2DM. Interestingly, high-density lipoprotein cholesterol (HDL-C) was significantly increased in women without T2DM after four weeks compared with baseline.

The mean values of glycemia in all groups significantly decreased after two and four weeks of SAE treatment. Markers of hepatic function — especially aspartate aminotransferase — also significantly improved after two and four weeks of SAE treatment in several groups. Levels of C-reactive protein (CRP), a marker of inflammation, significantly improved in women without T2DM after two and four weeks. In the same population, white blood cell counts significantly improved after four weeks. Except for a significant increase in platelet counts after four weeks of SAE treatment in men and women with T2DM, no statistically significant differences were observed in hematological parameters (red blood cell counts and hemoglobin and iron levels) among the groups.

Daily supplementation with SAE for four weeks correlated with significant reductions in body weight, waist size, blood pressure, and serum blood glucose in all groups. SAE also was associated with significant improvements in blood lipids, mainly LDL-C and total cholesterol, and markers of hepatic function and inflammation in some groups.

While the exact mechanisms behind SAE’s favorable effects on body composition, blood pressure, blood lipids, glycemia, hepatic function, and inflammatory markers remain unknown, the extract’s polyphenol content is thought to play a role in these outcomes by reducing oxidative stress. However, with no control group, a lack of blinding, and other confounding factors related to lifestyle and pharmacotherapy, additional trials are needed to confirm the effects of SAE on improving MetS and whether these effects are clinically significant.