Does pomegranate juice lower cholesterol?

Not by much, if at all. The newest meta-analysis of pomegranate juice alone, 17 randomized trials in 663 adults, found LDL cholesterol 4.8 mg/dL lower, triglycerides 8.2 mg/dL lower and HDL 2.8 mg/dL higher, with no overall effect on total cholesterol. Its abstract gives no confidence intervals and reports high variation between trials, with larger effects in people with metabolic disorders. An older review of 12 placebo-controlled trials in 545 people found no significant effect on any blood fat.

Unsettled. The answer stays open because the reviews point in different directions. The newest one finds small shifts in LDL, HDL and triglycerides. The older one finds nothing. The widest one, covering every pomegranate product, finds no change in LDL or triglycerides. In people with type 2 diabetes the pooled trials found no change at all. None of the trials made LDL in people with high cholesterol its main question at scale.

What the trials found

The meta-analyses

The 2026 review is the only one limited to juice: 17 trials, 663 adults. LDL fell by 4.8 mg/dL and triglycerides by 8.2 mg/dL, and HDL rose by 2.8 mg/dL. We read the abstract only, the intervals were not in it, and the review sits outside our PubMed copy, so we checked its wording twice on the journal and Europe PMC pages.

A 2016 meta-analysis of 12 placebo-controlled trials in 545 people, juice and extracts together, found no significant effect on total, LDL or HDL cholesterol or triglycerides. It also found no link with how much juice people drank a day. A 2025 meta-analysis of 53 trials in 2,306 people took in juice, extract, seed and peel. It found a standardized fall in total cholesterol of 0.12 (95% CI -0.24 to -0.00), an interval whose upper end touches zero, and a standardized rise in HDL of 0.27 (95% CI 0.08 to 0.47). LDL and triglycerides did not change. Standardized differences cannot be read as mg/dL.

In type 2 diabetes, a 2020 meta-analysis of 7 trials in 350 people found pomegranate did not significantly change blood fats, blood sugar markers or oxidative stress markers. A meta-analysis of 128 trials of polyphenol-rich foods found that nuts and berries lowered total cholesterol more clearly than pomegranate and grapes did. Its abstract gives no separate number for pomegranate.

Single trials

In 60 people with type 2 diabetes in Iran, 6.8 fl oz (200 mL) of juice a day for 6 weeks left total, LDL and HDL cholesterol and triglycerides no different from a group that drank nothing. Total and LDL cholesterol fell within the juice group against its own starting values, which is not a comparison with control. In an 8-week triple-blind trial in women with polycystic ovary syndrome, 10 fl oz (300 mL) a day of juice raised HDL against placebo. Lower total and LDL cholesterol appeared only in the arms given a synbiotic drink, and the abstract gives neither the number of women nor the size of the effects.

The longest trial gave 289 adults at moderate heart risk, men aged 45 to 74 and women aged 55 to 74, 8.1 fl oz (240 mL) of juice or a control drink for up to 18 months. Its outcome was thickening of the neck artery wall, and there was no overall difference between groups. Slower thickening appeared only in exploratory subgroups with an unfavorable triglyceride and HDL profile.

Myth. A study often cited as proof that pomegranate juice lowers cholesterol gave 22 people with diabetes and high blood fats 40 g a day of concentrated juice for 8 weeks and saw total and LDL cholesterol fall. It had no control group, so it cannot separate the juice from anything else that changed in those 8 weeks.

For the rest of what the drink does, see the pomegranate juice page.

Who should be careful

Not for everyone. If you take a statin and are drinking juice for your cholesterol, know about one case report. A 48-year-old man on rosuvastatin and ezetimibe, who may have had an underlying muscle disease, developed severe muscle breakdown three weeks after starting 6.8 fl oz (200 mL) of pomegranate juice twice a week, with creatine kinase at 138,030 U/L against a normal level under 200. One case does not show the juice caused it.

The reassuring side comes from a small trial. In 12 healthy adults, 8.5 fl oz (250 mL) of juice a day for 3 days did not significantly change blood levels of midazolam, a drug cleared by the same liver enzyme, CYP3A4, as several statins. Grapefruit juice raised midazolam exposure by 75% in the same trial. That is a short test in healthy people, and it says nothing about rosuvastatin directly.

Warfarin is the second medicine with a report. A 64-year-old woman on steady warfarin drank pomegranate juice 2 to 3 times a week, and when she stopped, her INR fell below target and her dose had to be raised. That is again a single case. Whatever you drink, keeping the amount steady and telling the doctor who manages your INR is the safer course.

A typical 248 g glass of 100% pomegranate juice carries about 134 calories, 31 g of sugars and 531 mg of potassium, according to USDA food data. The trials used 6.8 to 10 fl oz (200 to 300 mL) a day, which adds that sugar every day, and that matters for people with diabetes or high triglycerides. In 24 people on hemodialysis, 3.4 fl oz (100 mL) before each session for 4 weeks was safe and well tolerated in a pilot trial and did not change blood fats or blood pressure. The potassium is the reason anyone on dialysis should agree juice amounts with their renal team. Pomegranate can also cause IgE allergy: a 7-year-old with asthma developed bronchospasm moments after eating the seeds.

What expert bodies say

The NIH National Center for Complementary and Integrative Health, in a page updated in April 2025, says studies of pomegranate products have not shown clear effects on cholesterol or other blood lipids. It calls pomegranate juice believed to be safe, and notes that digestive symptoms and allergic reactions have been reported. Its summary predates the 2026 meta-analysis above.

How we searched

What would change this answer

• A placebo-controlled trial of pomegranate juice with LDL as the main outcome, large enough to matter, in people with raised LDL who are not on statins.
• Any trial measuring heart attacks or strokes rather than blood fats. We found none, and no trial registered in the local ClinicalTrials.gov index.
• The confidence intervals of the 2026 meta-analysis, which would show whether its small LDL change is clearly away from zero.

Sources

1. ev-pomjch-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 17 RCTs, 663 participants
   PJ consumption was associated with significant reductions in TG (MD: -8.2 mg/dL) and LDL-C (MD: -4.8 mg/dL), and a significant increase in HDL-C (MD: +2.8 mg/dL).
   
   Who: adults in randomized controlled trials of pomegranate juice reporting lipid outcomes
   Effect: TG MD -8.2 mg/dL; LDL-C MD -4.8 mg/dL; HDL-C MD +2.8 mg/dL; TC no overall effect; high heterogeneity; effects larger in metabolic disorders
   Certainty: The newest MA specifically on juice. CI not given in the abstract; heterogeneity high; LDL -4.8 mg/dL is less than any statin gives. PMID outside the corpus.
   Avicenna Journal of Phytomedicine, 2026 (pomegranate juice consumption and lipid profile: updated systematic review and meta-analysis) · checked 2026-10-07 · we read the abstract
2. ev-pomjch-02 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 545 individuals, 12 RCTs
   Fixed-effect meta-analysis of data from 12 RCTs (13 treatment arms) did not show any significant effect of pomegranate consumption on plasma lipid concentrations.
   
   Who: participants of randomized placebo-controlled trials of pomegranate
   Effect: no significant pooled effect on TC, LDL-C, HDL-C or TG (fixed effects); no link with daily juice amount
   Certainty: Older pool; fixed effects; juice and extracts together.
   Phytomedicine, 2016 · checked 2026-10-07 · we read the abstract
3. ev-pomjch-03 · Meta-analysis or systematic review · systematic review and dose-response meta-analysis of randomized controlled trials · n = 53 RCTs, 2306 participants
   No substantial changes were observed in waist-to-hip ratio (WHR), homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference (WC), serum values of hemoglobin A1c (HbA1c), alanine transaminase (ALT), triglycerides (TG), low-density lipoprotein (LDL), insulin, and aspartate transferase (AST) levels between PO and placebo groups.
   
   Who: adults in RCTs of pomegranate supplementation (juice, extract, seed, peel)
   Effect: TC SMD -0.12 (95% CI -0.24 to -0.00); HDL SMD 0.27 (0.08 to 0.47); no substantial change in LDL or TG
   Certainty: SMD, not mg/dL; the upper CI bound for TC is at zero. All forms of pomegranate, not only juice. No full text in PMC.
   Nutr Metab Cardiovasc Dis, 2025 · checked 2026-10-07 · we read the abstract
4. ev-pomjch-04 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 7 trials, 350 participants
   The results of the meta-analysis revealed that pomegranate supplementation did not have any significant effects on metabolic status and oxidative stress biomarkers of subjects with T2DM.
   
   Who: adults with type 2 diabetes in RCTs of pomegranate supplementation
   Effect: no significant effect on TG, TC, HDL-C, LDL-C, glycemic or oxidative stress markers
   Certainty: Small pool, different forms of pomegranate.
   Complement Ther Med, 2020 · checked 2026-10-07 · we read the abstract
5. ev-pomjch-05 · Meta-analysis or systematic review · meta-analysis of randomized clinical trials · n = 128 RCTs
   Both anthocyanin- and ellagitannin-containing products reduced total-cholesterol with nuts and berries yielding more significant effects than pomegranate and grapes.
   
   Who: participants of RCTs of berries, red grapes or wine, nuts and pomegranate
   Effect: total cholesterol reduced by ellagitannin and anthocyanin products; nuts and berries more significant than pomegranate and grapes
   Certainty: Comparison of foods, abstract without numbers for pomegranate separately.
   Int J Mol Sci, 2018 · checked 2026-10-07 · we read the abstract
6. ev-pomjch-06 · Randomized controlled trial(s) · single-blind randomized clinical trial · n = 60 (30 per group)
   At the end of the intervention, TC, TG, LDL-C and HDL-C did not significantly differ between the intervention group and the control group however, TC and LDL-C decreased significantly compared to pre-trial values within the intervention group.
   
   Who: patients with type 2 diabetes, Iran, 200 mL/day for 6 weeks vs no intervention
   Effect: TC, TG, LDL-C and HDL-C no between-group difference; TC and LDL-C fell only within the juice group
   Certainty: Control without a drink; the fall is only "from baseline," not evidence of an effect.
   Clin Nutr ESPEN, 2019 · checked 2026-10-07 · we read the abstract
7. ev-pomjch-07 · Randomized controlled trial(s) · randomized triple-blinded placebo-controlled 4-arm trial, 8 weeks · n = —
   Compared to placebo, Total Cholesterol (TC) was lower in the SB group (P < 0.01), LDL-c was lower in the SPJ and SB groups (P < 0.01), and HDL-c was higher in the SPJ and PJ groups (P < 0.01).
   
   Who: females with polycystic ovary syndrome, 300 mL/day pomegranate juice, synbiotic beverage, synbiotic pomegranate juice or placebo
   Effect: vs placebo: HDL-c higher with PJ and synbiotic PJ (P < 0.01); TC lower only with synbiotic beverage; LDL-c lower with synbiotic drinks
   Certainty: No N in the abstract; no effect numbers; one population.
   J Endocrinol Invest, 2020 · checked 2026-10-07 · we read the abstract
8. ev-pomjch-08 · Randomized controlled trial(s) · randomized double-blind parallel trial · n = 289 (146 juice, 143 control)
   No significant difference in overall CIMT progression rate was observed between pomegranate juice and control treatments.
   
   Who: men 45-74 and women 55-74 years with at least 1 major CHD risk factor
   Effect: no difference in overall CIMT progression; slower progression only in exploratory subgroups with adverse TG/HDL profile
   Certainty: Subgroups are exploratory; lipids were not the primary endpoint.
   Am J Cardiol, 2009 · checked 2026-10-07 · we read the abstract
9. ev-pomjch-09 · Observational data · quasi-experimental before-after study without control group · n = 22
   After consumption of CPJ, significant reductions were seen in total cholesterol (P <.006), low-density lipoprotein (LDL)-cholesterol (P <.006), LDL-cholesterol/high-density lipoprotein (HDL)-cholesterol (P <.001), and total cholesterol/HDL-cholesterol (P <.001).
   
   Who: type II diabetic patients with hyperlipidemia (cholesterol >= 201 mg/dL (5.2 mmol/L) or TG >= 204 mg/dL (2.3 mmol/L)), Iran
   Effect: TC (P < .006) and LDL-C (P < .006) fell; TG and HDL unchanged
   Certainty: No control; often cited as "evidence": level C.
   J Med Food, 2004 · checked 2026-10-07 · we read the abstract
10. ev-pomjch-10 · Position of an expert body · agency summary of research · n = —
    Studies have been done to see whether various products from pomegranate can influence levels of cholesterol and other lipids, but no clear effects have been demonstrated.
    
    Who: general public, US
    Effect: no clear effect on cholesterol and lipids
    Certainty: Authority position for 2025; the new 2026 MA (ev-pomjch-01) gives small LDL/HDL shifts.
    NIH National Center for Complementary and Integrative Health, Pomegranate: Usefulness and Safety, updated April 2025 · checked 2026-10-07 · we read the section
11. ev-pomjch-11 · Position of an expert body · agency summary of research · n = —
    Pomegranate juice is believed to be safe.
    
    Who: general public, US
    Effect: juice believed safe; root, stem, peel in large amounts may not be
    Certainty: General assessment, without dose limits.
    NIH National Center for Complementary and Integrative Health, Pomegranate: Usefulness and Safety, updated April 2025 · checked 2026-10-07 · we read the section
12. ev-pomjch-12 · Randomized controlled trial(s) · open-label three-way crossover · n = 12
    Slight but not statistically significant changes were observed in the pharmacokinetics of dapoxetine and midazolam after pretreatment with PJ.
    
    Who: 12 healthy subjects, 8.5 fl oz (250 mL) water, grapefruit or pomegranate juice for 3 days before dapoxetine 60 mg and midazolam 7.5 mg
    Effect: pomegranate juice: slight, non-significant changes; grapefruit juice: midazolam AUC +75%
    Certainty: CYP3A4 clears simvastatin, lovastatin, atorvastatin; small and healthy pool.
    Eur J Drug Metab Pharmacokinet, 2017 · checked 2026-10-07 · we read the abstract
13. ev-pomjch-13 · Laboratory or animal data · case report · n = 1
    Three weeks before presentation, he began drinking pomegranate juice (200 ml twice weekly). He presented urgently with thigh pain and an elevated serum creatine kinase level (138,030 U/L, normal < 200 U/L).
    
    Who: one 48-year-old man with possible underlying myopathy on rosuvastatin 5 mg every other day and ezetimibe 10 mg/day
    Effect: creatine kinase 138,030 U/L (normal under 200)
    Certainty: A single case, possible primary myopathy; causality not established. Those who ask about cholesterol are often on statins.
    Am J Cardiol, 2006 · checked 2026-10-07 · we read the abstract
14. ev-pomjch-14 · Laboratory or animal data · case report · n = 1
    During that time, the patient was consuming pomegranate juice 2-3 times/week. She stopped drinking the juice, and her INRs became subtherapeutic.
    
    Who: one 64-year-old woman on warfarin for recurrent deep vein thrombosis
    Effect: INR subtherapeutic after stopping juice; warfarin dose raised
    Certainty: A single case; human PK data on CYP2C9 are null. Keep a steady juice volume and tell the doctor.
    Pharmacotherapy, 2009 · checked 2026-10-07 · we read the abstract
15. ev-pomjch-15 · Randomized controlled trial(s) · randomized crossover pilot trial, juice vs extract · n = 24
    Both pomegranate juice and extract are safe and well tolerated by patients undergoing MHD but do not influence markers of inflammation or oxidative stress nor affect predialysis blood pressure.
    
    Who: patients on maintenance hemodialysis, mean age 61 years
    Effect: safe and well tolerated; no change in lipids, inflammation, oxidative stress or predialysis BP
    Certainty: Pilot; the juice's potassium matters for dialysis, hence small portions.
    J Ren Nutr, 2015 · checked 2026-10-07 · we read the abstract
16. ev-pomjch-16 · Position of an expert body · reference dataset, not a study · n = 1 food code
    FNDDS 2709330 Pomegranate juice, 100% (64126000): Energy 54 kcal/100 g, Quantity not specified 248 g 133.9 kcal · Total Sugars 12.65 g/100 g, 248 g 31.4 g · Potassium, K 214 mg/100 g, 248 g 530.7 mg · Vitamin C, total ascorbic acid 0.1 mg/100 g, 248 g 0.2 mg · 1 fl oz (no ice) 31 g
    
    Who: US household measures, FNDDS
    Effect: per 248 g: 133.9 calories, total sugars 31.4 g, potassium 530.7 mg
    Certainty: Doses in the RCT of 200-300 mL per day add this sugar; important in diabetes and for TG.
    USDA FNDDS 2021-2023 · checked 2026-10-07 · we read the dataset
17. ev-pomjch-17 · Laboratory or animal data · case report · n = 1
    We present the case of a 7-year-old IgE-dependent asthmatic child who, moments after ingesting several pomegranate seeds, showed a clinical condition of bronchospasm which responded to treatment with inhaled salbutamol.
    
    Who: one 7-year-old IgE-dependent asthmatic child
    Effect: bronchospasm; positive prick-by-prick test; RAST 0.8 PRU/ml
    Certainty: Rare allergy; cross-reactivity with peach LTP (other reports in the corpus).
    J Investig Allergol Clin Immunol, 1992 · checked 2026-10-07 · we read the abstract