Fruit‐ and Vegetable‐Derived Polyphenols Improve Metabolic and Renal Outcomes in Adults with Metabolic Syndrome and Chronic Kidney Disease: A Systematic Review of Randomized Controlled Trials
DOI:
https://doi.org/10.12873/452hadinataPalabras clave:
Dietary polyphenols, Metabolic syndrome, Chronic kidney disease, Endothelial function, Randomized controlled trialsResumen
Background: Metabolic syndrome (MetS) and chronic kidney disease (CKD) share features such as inflammation and oxidative stress. Fruit- and vegetable-derived polyphenols may modulate these mechanisms.
Objective: To evaluate effects of fruit- and vegetable-based polyphenol interventions on metabolic and renal outcomes in adults with MetS or CKD/ESRD.
Methods: We systematically reviewed randomized controlled trials comparing polyphenol-rich whole foods or supplements versus control. Data on lipids, blood pressure, glucose, endothelial function, estimated glomerular filtration rate (eGFR), albuminuria, and cardiovascular events were extracted and narratively synthesized.
Results: Twenty-eight RCTs (n = 20–108) were included. In MetS, bergamot extract (six months) reduced LDL by 22 % and triglycerides by 23 % (p < 0.01). Grape powder (60 g/day for four weeks) lowered triglycerides and improved HDL function. Freeze-dried blueberry (45 g/day for six weeks) enhanced endothelial function (p < 0.05). Blood pressure reductions occurred with grape polyphenols; glycemic improvements were limited to polyphenol-rich diets and high-dose resveratrol. In CKD, fruit and vegetable diets (up to five years) slowed eGFR decline and increased plasma bicarbonate to levels comparable to sodium bicarbonate. Long-term interventions (five years) reported zero cardiovascular events versus six in controls (p < 0.01). Isolated supplements (e.g., cranberry, resveratrol) showed minimal effects on renal function. No serious adverse events were reported.
Conclusions: Whole-food polyphenol interventions improve lipid profiles, endothelial function, and slow renal decline in MetS and CKD populations. Glycemic benefits are modest. Standardized, long-term RCTs are needed to refine dietary guidelines.
Referencias
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