Beverages, along with diet and other lifestyle factors, can influence many processes in the body that affect diseases, the authors note, citing the way coffee or tea seem to decrease inflammation while other drinks alter the gut microbiome, which interacts with the immune system. RELATED: 7 Foods That Fight Back: Immune System Boosters
Pomegranate Juice Is Especially Intriguing for RA
Juices from fruits rich in naturally occurring antioxidants found in certain plants, known as polyphenols, have gotten extra attention from researchers. The Nutrients authors wrote that fruit juices have been linked to beneficial effects for several conditions, including diabetes, inflammatory bowel disease, atherosclerosis, and certain metabolic disorders. Pomegranates especially have been a research focus. These deep red fruits with hard skin surrounding ruby-red seeds (known as arils) are being called a superfood. Their juice, once a niche product, can now be purchased in many supermarkets and other stores that sell groceries. RELATED: RA-Friendly Foods: Inflammation-Fighting Desserts
Potential Health Benefits of Pomegranate Juice
Research on mice has shown that pomegranate extract reduces the severity of collagen-induced arthritis, joint inflammation, and levels of the blood inflammatory marker interleukin 6 (IL-6). Other studies have looked into the juice’s possible effect on heart disease, a condition that’s considered a comorbidity for people with RA. Most of those studies have been done in test tubes or in mice, but a small number have been done in humans. One study, published in the British Journal of Nutrition, found a significant decrease in triglycerides, a fat found in the blood, after subjects took 400 milligrams (mg) of pomegranate seed oil a day for one month (participants’ total blood cholesterol did not go down).
Early but Promising Anti-Inflammation Effects
In a review published in Advanced Biomedical Research, Iranian scientists called the pomegranate “a potent antioxidant,” and said the various compounds found in the fruit have antihypertensive and anti-inflammatory properties, among other benefits. A promising study published in the European Journal of Clinical Nutrition in January 2017 compared subjects given two 250 mg capsules of pomegranate extract a day with those taking a placebo. At the end of two months, people taking the extract reported less joint swelling and pain intensity, plus higher blood levels of glutathione peroxidase (GPx), which helps protect against oxidative damage. (C-reactive protein, erythrocyte sedimentation rate, and other important blood markers remained unchanged.) RELATED: Watch Out for These Rheumatoid Arthritis Alternative Therapies
More Robust Studies Are Still Needed
Experts caution that while these results are promising for people with RA, larger studies in humans are needed to confirm them and provide better guidance on the amount and form of pomegranate or its juices that might be most effective.
Pomegranate Juice and Possible Drug Interactions
Further complicating the picture are questions about whether pomegranate juice, like grapefruit juice, might affect the absorption rates of commonly used medications. “The absorption issue for drugs is a potential problem with pomegranate juice,” says Gustavo Carbone, MD, a rheumatologist at the University of Miami Health System in Florida. That’s because the fruit has been shown in the lab to interfere with CYP3A4 and CYP2C9, the same intestinal enzymes that grapefruit juice is known to inhibit. The list of drugs that should not be taken with grapefruit juice is long. It includes some statin drugs that lower cholesterol, including Zocor (simvastatin), Lipitor (atorvastatin), and Pravachol (pravastatin); some blood pressure-lowering drugs, like Afeditab CR (nifedipine); some anti-anxiety medications, such as BuSpar (buspirone); anti-arrhythmia medications like Cordarone (amiodarone); and others. The U.S. Food and Drug Administration (FDA) warns that drinking grapefruit juice when you’re on these medications prevents the drug from being fully metabolized, so more might enter the bloodstream and stay there longer, resulting in potentially dangerous levels of the drug in your body and in additional side effects. RELATED: 5 Foods People With RA Should Avoid
Be Cautious and Careful for Now
It’s less clear whether pomegranate juice has the same effect, because few studies have been done in people. Research published in the European Journal of Drug Metabolism and Pharmacokinetics concludes that, while it’s possible that pomegranate juice may create drug metabolism issues, no one can say for sure without more research. In one Korean study testing both pomegranate and grapefruit juices with the statin drug Zocor (simvastatin), for example, published in the same journal in February 2015, the grapefruit juice affected the medication but the pomegranate juice did not. Still, until additional research clarifies the matter, if your doctor has told you to steer clear of grapefruit juice because of a medication you’re taking, you may want to avoid the seedy pomegranate fruit along with its juice and extracts too — and have an apple instead.
