One more hearty cheer for pomegranate

Q: Could you talk more about whether pomegranate is also good for heart disease? I heard that it helps open up blocked arteries. Is that true?

A: Thanks for your question. Here goes part two of the pomegranate story...

A lot of people have heard about using pomegranate for heart disease because of a study published in the American Journal Cardiology two years ago. In that study, 45 patients with heart disease and ischemia (ischemia means that they had trouble getting good circulation to their hearts) drank either 3 cups of pomegranate juice or a flavored drink for three months.

They got scans to check the blood flow to their hearts before and after. The people who drank pomegranate juice had better blood flow to their hearts on the scans. In contrast, the people who drank the flavored beverage didn't just stay the same — they actually had worse blood flow, despite the fact that everyone had stable blood pressure, blood sugar and medications.

The caveat to this study is that it was small. Otherwise, I think it was well designed, and the results are interesting. The results seem to go along with another study I want to tell you about.

In 2004, researchers took 10 people with plaque buildup in their carotid arteries. The nice thing about the carotid arteries (other than that they help your brain to get blood so you can think) is that they are located in the neck. This makes it easy to measure how much plaque they have using a simple sound-wave probe.

These 10 people drank pomegranate juice for one year, and the thickness of the plaque dropped by up to 30 percent, and one of their blood pressure numbers (the systolic blood pressure) dropped by 21 percent. By comparison, the people in the study who did not drink the juice had an increase in plaque thickness of 9 percent.

Again, the downside here is that this is a small study. However, it seems to correlate with the results found above, and I think it is worth pursuing further — especially since pomegranate juice costs about $5 at the store. Who knows, it may even save our financially strained health-care system a few dollars if it turns out to work as well as it seems to in these studies.

Some think that pomegranate helps plaque buildup by lowering cholesterol. But the jury is still out. One study say "yes," and another says "no." So, most likely, pomegranate helps circulation by another mechanism.

Although it isn't entirely clear yet, pomegranate juice may work because it is a good antioxidant. This may help the type of cholesterol that goes into the plaque to be less irritating to the artery wall, which could cause less plaque to form. Also, pomegranate helps increase the amount of a compound called "nitric oxide" which helps to open up blood vessels.

If you are going to try pomegranate juice, go for the long haul; you probably need to use it for at least one year to reap the benefits. As I mentioned in the last article, for those who prefer to use the juice concentrate instead of the juice itself to avoid some of the calories, that is probably fine. There is no proof at this point that capsules have the same effect as the juice itself.

Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish/Cherry Hill hospitals. Send questions to apujari@seattletimes.com for possible use in future columns. All information is intended for education and not a substitute for medical advice. Consult your doctor before following any suggestions given here.