Effects of Bread Fortification With Pomegranate Peel Powder on Inflammation Biomarkers, Oxidative Stress, and Mood Status in Patients With Type 2 Diabetes: A Randomized Placebo‐Controlled Trial

We hypothesized that bread fortified with pomegranate peel powder (PPP) would improve inflammation, oxidative stress, and mood in patients with type 2 diabetes mellitus (T2DM). To confirm this, its effect on the parameters above was evaluated. In total, 90 T2DM patients were randomized to receive either bread fortified with 3.5% PPP (N = 45) or PPP-free bread for 12 weeks (N = 45). Dietary intake throughout the trial was assessed via food records. Laboratory parameters, including total antioxidant capacity (TAC), malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), and psychological disorders, including depression, anxiety, and stress, were assessed at the beginning and end of the study. 77 diabetic patients completed the trial (PPP group = 39 and control group = 38). Based on the compliance assessment, adherence to the interventions was high in the trial. We detected significant reductions in hs-CRP levels (intervention group: change = -0.56 ± 1.29, p = 0.01; control group: change = -0.81 ± 1.16, p < 0.001) and depression scores (intervention group: change = -1.33 ± 3.66, p = 0.04; control group: change = -1.44 ± 2.83, p = 0.01). There was no significant difference between the groups. After adjusting for confounding factors, the important effect within the group disappeared. Other variables, including MDA, TAC, anxiety, and stress, did not significantly change in the two study groups. Whereas 12 weeks of consumption of PPP-fortified bread failed to significantly affect oxidative stress, hs-CRP levels, or mental state in T2DM patients, partial beneficial effects on inflammation and mood suggest the need for further research.