Here are all the ways this water-packed summer staple can revolutionize your dietary health. By Good Housekeeping Magazine. Nothing tastes like summer more than a crisp, juicy, refreshing slice of watermelon.

Watermelon — which can actually be considered a fruit or a vegetable, according to the National Watermelon Promotion Board — is incredibly nutritious, too.

Nutritionists say watermelon is low in calories and sugar and chock-full of vitamins, minerals, and antioxidants, making it a great addition to a healthy diet. According to the U. Department of Agriculture , 1 cup of watermelon g contains:.

Different fruits contain different nutrients, so eating a variety will ensure your body gets everything it needs. People with diabetes or who may need to count their carbohydrate servings should also pay attention to their watermelon intake, she adds.

Eating too much fruit could introduce too much sugar to your diet, leading to blood sugar fluctuations , which can be risky for people with diabetes. At just 46 calories per cup , watermelon packs a punch when it comes to nutrients.

Vitamin C strengthens your immune system and helps the body absorb iron, Derocha says, while vitamin A is crucial for skin and eye health.

Watermelon is also rich in potassium, which works to lower blood pressure and supports nerve functioning, and vitamin B6, which helps the body break down the proteins that you eat and also boosts the immune system and nerve function.

Lycopene is a natural compound found in watermelon and other fruits and vegetables that has antioxidant properties. The substance is also what gives watermelon its red color; but beyond its hue, lycopene is also good for you, too.

Isomerization of the all-trans isomer into the more bioavailable cis-isomer, occurs under acidic conditions e. Lycopene can be found in tomatoes, watermelon, papaya, red grapefruits, apricots, and guava, and gives their red color Kong et al. Lycopene content increases during different stages of ripening of fruits, e.

Watermelon pulp can also be used for lycopene extraction Oberoi and Soqi, and is a rich source of cis-isomeric lycopene, abundant in higher concentrations than in tomatoes Naz et al.

Interestingly also the fungal plant pathogen Blakeslea trispora has been recognized as a commercial source to produce lycopene Mantzouridou and Tsimidou, Several foods high in lycopene content are classified as functional foods Naz et al.

Tomato juice, paste, puree, ketchup, sauce or soup represent lycopene sources with improved bioavailability due to thermal treatment, but also because processing releases lycopene from the fibrous cell structure matrix Basu and Imrhan, ; Thies et al.

Not only lycopene intake counts, but also its serum concentration may influence cardiovascular risk. Low serum and adipose tissue lycopene levels were correlated with early atherosclerosis, and major acute coronary and cerebrovascular events, and were found to be more reliable in risk assessment than the daily intake of lycopene Agarwal and Rao, ; Rissanen et al.

Oxidative stress and inflammation are responsible for a reduced level of antioxidants Kim et al. Smoking is a potent oxidative stressor, able to impair arterial elasticity and endothelial function Kim et al.

Lycopene has several cardiovascular beneficial effects, such as an antioxidative, antiinflammatory, anti-atherogenic, cardioprotective, and antiplatelet effect, improving endothelial function nitric oxide bioavailability and blood flow , the metabolic profile by impairing cholesterol synthesis and blood pressure control Figure 2 Klipstein-Grobusch et al.

Figure 2. Lycopene is considered an effective singlet oxygen quencher in the carotenoids group Kong et al. It is a much more potent antioxidant than alpha-tocopherol 10 × more potent or beta-carotene twice as potent Kim et al.

Lycopene modulates also the production of antioxidant enzymes, such as superoxide dismutase and catalase Böhm, ; Pereira et al. Lycopene can also scavenge peroxynitrite, resulting oxidized lycopene products Pisoschi and Pop, Oxidative stress causes endothelial dysfunction due to uncoupling of the nitric oxide synthase and oxidative injury of the endothelial cells Mozos and Luca, Both are associated with inflammation.

By reducing oxidative stress and reactive oxygen species, lycopene increases the bioavailability of nitric oxide NO , improves endothelium-dependent vasodilation and reduces protein, lipids, DNA, and mitochondrial damage Hollman et al.

Endothelial NO enables vasodilation, inhibits platelet functions, and adhesion and transmigration of white blood cells, and reduces smooth muscle cell proliferation Opatrilova et al. Watermelon supplementation, due to L-citrulline content, increases plasma L-arginine, enabling NO production Figueroa et al.

Lycopene supplementation improved endothelial mediated vasodilation in cardiovascular disease patients, but not in healthy controls Gajendragadkar et al. In summary, lycopene scavenges both reactive oxygen and nitrogen species, increases the production of antioxidant enzymes and protects the endothelial cells from oxidative damage.

Inflammation is related to atherosclerosis, arterial stiffness, and major cardiovascular events. The anti-inflammatory role of lycopene was demonstrated by several studies Hung et al. Hung et al. revealed that lycopene can inhibit TNF-alpha induced NF-kappa B activation, expression of intracellular adhesion molecule-1 ICAM-1 , and interaction between monocytes and endothelial cells, which might explain the cardiovascular benefits of lycopene Hung et al.

In a different study with Korean women, lycopene levels were found to correlate with cytokines, but no correlation with acute phase reactants was found, probably due to lycopene's inhibitory effect on the formation of oxidized LDL Kim et al.

Xu et al. found an inverse association of lycopene with vascular cell adhesion protein 1 VCAM-1 , which enable adhesion of monocytes to the endothelial cells, but could not verify any association between serum lycopene concentration and atherosclerosis in their study as suggested by earlier studies Xu et al.

In the same context, Gianetti et al. reported no significant correlations between plasma lycopene and soluble adhesion molecules Gianetti et al. Lycopene obtained from red guava exerts several anti-inflammatory effects besides modulation of inflammatory mediators, such as inhibition of leukocyte mobilization, stabilization of mast cells, and inhibition of genes which expression is involved in inflammation Vasconcelos et al.

Lycopene can also reduce the secretion of metalloproteinases by macrophages and inhibit T lymphocyte activation Thies et al. Recently, lycopene was found as an effective antiglycation agent, able to reduce the synthesis of advanced glycation end-products AGE , downregulating the expression of their receptors RAGE , which further contributes to vessel protection Tabrez et al.

Tomato products reduced oxidative stress related to postprandial lipemia and the associated inflammatory reaction in a study including normal weight participants Burton-Freeman et al.

He et al. reported the benefits of lycopene in preventing transplant vasculopathy, demonstrating that intimal hyperplasia and smooth muscle cell proliferation were reduced by the administration of lycopene and the infiltration of inflammatory cells in allograft vessels was reduced in an animal model He et al.

On the other hand, the benefits of the tomato-rich diet were not directly related to the anti-inflammatory effect according to a randomized study including apparently healthy volunteers, after g tomatoes daily for 1 month or placebo Blum et al. Watermelon was shown to reduce levels of inflammation by downregulation of the proinflammatory mediator cyclooxygenase 2 COX-2 , impairing prostaglandin E2 and I2 production, which reduces the progression of cardiovascular disorders Sellers et al.

Watermelon powder supplementation exerts an anti-inflammatory effect similar to COX-2 inhibitors or conventional non-steroidal anti-inflammatory drugs Hong et al. High mobility group box 1 HMGB1 , a non-histone DNA binding protein, produced by necrotic and immune cells, exposed to pro-inflammatory signals, has an important pro-inflammatory effect by attracting and activating inflammatory cells and mediators and binding to RAGE and toll-like receptors, related to fatal outcomes Lee et al.

Lee et al. demonstrated that lycopene inhibits adhesion molecules expression, which impair HMGB1—induced monocyte adhesion and transmigration Lee et al. Lycopene has been also shown to inhibit lipopolysaccharide-induced HMGB1 release and HMGB1-mediated secretion of TNF-alpha and secretory phospholipase A2 Lee et al.

Oxysterols, the result of cholesterol auto-oxidation, accumulate in the subendothelial arterial layer, exerting oxidative and pro-inflammatory roles and favoring the atherosclerotic process Palozza et al.

Lycopene impairs oxysterol-induced pro-inflammatory cytokines production in human macrophages and oxysterol-induced ROS production, limiting the formation of atherosclerotic plaque Palozza et al.

Lycopene exerts a cardioprotective effect against atrazine induced cardiac injury due to its anti-inflammatory effect, by blocking the NF-kappa B pathway and NO production Li et al. Considering the mentioned anti-inflammatory mechanisms Figure 3 , including decrease of adhesion molecules, pro-inflammatory cytokines, inhibition of leukocyte migration and genes involved in inflammation, impaired monocyte-endothelium interaction, T lymphocytes activation and synthesis of AGE and RAGE and downregulation of cyclooxygenase 2, lycopene can be useful in the therapy for vascular inflammatory disorders.

Figure 3. Anti-inflammatory effects of lycopene. MMPs, matrix metalloproteinases; COX-2, cyclooxigenase 2; AGE, advanced glycation end-products; RAGE, receptors of AGE.

Lycopene is transported in the circulation by lipoproteins and is actively taken up into adipocytes McEneny et al. These results suggest that lycopene supplementation could be especially beneficial for patients with statin intolerance Sultan Alvi et al.

Changes in hepatic gene expression, such as reduced expression in fatty acid synthase, responsible for fatty acid storage, were described after watermelon powder consumption in rats Hong et al. Carbonic anhydrase III and adenylate kinase 2 were involved in the lipid-lowering and antioxidant effects of tomatoes Hsu et al.

On the other hand, NO stimulates fatty acid oxidation and lipolysis in adipose cells Jobgen et al. Fecal cholesterol excretion increases with levels of dietary lycopene due to decreased intestinal cholesterol absorption. This can be explained by the insight that increased fecal excretion impairs the enterohepatic circuit of bile acids, thus increasing the conversion of cholesterol to bile acids Verghese et al.

The lipid lowering properties of lycopene involve also an increased activity of LDL receptors in macrophages Li et al. Lycopene can lower synthesis of dysfunctional HDL, modulating HDL functionality toward an antiatherogenic phenotype, with a low serum amyloid A level and beneficial changes of the activity of HDL remodeling enzymes cholesterol ester transfer protein and lecithin cholesterol acyl transferase McEneny et al.

A hypotriglyceridemic effect of tomato juice was seen only in subjects with initial high serum triglyceride levels Li et al. Lycopen can also regulate the hepatic lipid metabolism and counteracts the hepatic steatosis induced by a high-fat diet, due to sirtuins SIRT1 induction and activation, being able to suppresses lipogenesis, to stimulate lipid catabolism in the liver and skeletal muscles and lipid mobilization in the white adipose tissue Lomb et al.

Another mechanism able to ameliorate liver steatosis, by lycopene, was described in mice and is related to decrease of fatty acid binding protein 7 due to binding to microRNA Ahn et al. In summary, lycopene has lipid lowering properties, reducing the total and LDL cholesterol, triglyceride level, LDL oxidation, and synthesis of dysfunctional HDL.

Platelets are involved in the pathogenesis of the atherosclerotic plaque, development of acute thrombotic events and restenosis after endovascular procedures Krasinska et al.

Another cardiovascular beneficial effect of lycopene, protecting against myocardial infarction and stroke, is its antiplatelet activity, which is concentration dependent, and was demonstrated in vivo and in vitro Sawardekar et al. Several mechanisms were considered in explaining the reversible antiplatelet effect of lycopene, such as the interaction with thromboxane, thrombin, collagen, von Willebrand factor, P-selectin and inflammatory mediators, the influence on calcium and cyclic guanosine monophosphate signaling and ADP-mediated aggregation Sawardekar et al.

It was noticed that lycopene can potentiate the antiplatelet effect of aspirin, which requires low lycopene diet in patients on secondary prophylaxis with aspirin due to the potential bleeding risk Sawardekar et al.

On the other hand, in high cardiovascular risk, aspirin ASP resistant patients, or those with ASP contraindications, high risk of complications after antiplatelet therapy or hyperactive platelets obese, sedentary, hypertensive, diabetic, aging patients, and smokers , lycopene could have an important contribution in cardiovascular prophylaxis Sawardekar et al.

Lycopene has antihypertensive effects due to inhibition of the angiotensin converting enzyme ACE and due to its antioxidant effect, reducing oxidative stress induced by angiotensin-II and indirectly enhancing production of nitric oxide in the endothelium Li and Xu, ; Belovic et al. Paran et al. reported a decrease in both systolic and diastolic blood pressure in 54 patients with moderate hypertension, treated with ACE inhibitors or calcium channel blockers, after 6 weeks of tomato extract supplementation, suggesting a cause-effect relationship Paran et al.

Li et al. Angiotensin II induces, besides direct vasoconstriction and oxidative stress, also vascular smooth muscle cells phenotypic transformation and production of inflammatory cytokines Ren et al. Besides improving endothelial function, oxidative stress preventing oxidation of LDL and metabolic profile, the anti-inflammatory and antiplatelet effect, lycopene has several other anti-atherosclerotic contributions Figure 4 , such as inhibition of vascular smooth muscle cell VSMC proliferation and foam cell formation Napolitano et al.

In general, not all studies confirm the relationship between lycopene and early atherosclerosis Kim et al. Figure 4. Anti-atherosclerotic effect of lycopene.

oxLDL, oxidized LDL; VSMC, vascular smooth muscle cells. Contractile VSMC change to a proliferative and migratory phenotype during the atherosclerotic process, enabling migration of VSMC into the intima and production of the extracellular matrix of the plaque Karagiannis et al.

Lycopene can suppress VSMCs proliferation, due to inhibiting G1 phase cells entry into the S phase of the cell cycle, related to its antioxidative effect Chen et al.

Minimally-oxidized LDL can induce phenotypic modulation of VSMC Karagiannis et al. Lycopene may block VSMC migration and proliferation also by direct binding to platelet-derived growth factor PDGF and inhibiting PDGF-signaling Lo et al.

Lycopene has also barrier integrity activity in the endothelial membrane, by blocking the activation of CD14 and Toll like receptor-4 expression Bae and Bae, and impairs the apoptosis of endothelial cells in vitro , by disrupting the upregulation of p53 and caspase 3 mRNA Tang et al.

Recent studies emphasized the cardioprotective effects of lycopene. An experimental study including rats with isoproterenol induced myocardial infarction, demonstrated improved ECG findings shorter QT and RR intervals and QRS complexes, reduced ST segment elevation if lycopene was previously administrated, related to its cell membrane stabilizing and antioxidant properties Aman et al.

Supplementation of lycopene in the same study also prevented alteration in hemodynamic parameters systolic, diastolic, and mean blood pressure , biochemical and inflammatory markers, apoptotic changes, and reduced the size of myocardial infarction due to the antioxidant and anti-inflammatory properties of lycopene Aman et al.

Tomato and lycopene supplementation attenuated cardiac-remodeling and improved diastolic dysfunction after myocardial infarction according to a study including male Wistar rats, enabled by impairing type I and type III collagen content in the left ventricle, reduced cardiomyocyte death, expression of miRNAs and by the anti-inflammatory effect and reduction of oxidative stress Pereira et al.

Wang et al. administered lycopene in infarcted rats for 28 days, revealing an increased ejection fraction compared to controls, associated with decreased collagen fraction in the peri-infarct zone, due to inhibition of p38 mitogen-activated protein kinase and matrix metalloproteinase 9 expression Wang et al.

Lycopene effect on interstitial collagen accumulation was not confirmed by Anjos Ferreira et al. The anti-inflammatory effect of lycopene has also a contribution in reversing ventricular remodeling, by inhibiting the nuclear factor-κB signaling pathway He et al.

Lycopene might also serve as a cardioprotective agent against several drugs. The cardioprotective effect of lycopene was demonstrated in the case of tulathromycin, a macrolide antibiotic, and diclofenac sodium, a non-steroidal anti-inflammatory drug, by Abdel-Daim et al.

Lycopene can also protect against the cardiotoxicity induced by doxorubicin Karimi et al. Concluding, lycopene supplementation is beneficial for early and late prognosis in myocardial infarction.

It may reduce myocardial infarction size and related electrocardiographic, hemodynamic, and biochemical changes Aman et al. Lycopene also reverses ventricular extracellular matrix remodeling after an acute coronary event, by inhibiting myocardial fibrosis and preventing apoptosis and necrosis of cardiomyocytes, its anti-inflammatory effect and the ability to increase left ventricular function, preventing development of heart failure and increasing survival rates Aman et al.

Considering difficulties and high cost of early revascularization and significant side effects of cardiovascular drugs, lycopene could represent a safe and effective option in controlling post infarction ventricular remodeling Wang et al.

The endoplasmic reticulum has several functions related to intracellular calcium storage, lipid and protein synthesis, and modification Schönthal, However, high lycopene levels might be toxic to the cardiomyocytes Gao et al. Lycopene supplementation for 4 weeks strongly reduced total and LDL serum cholesterol and the amount of cholesterol in the aorta, but the surface lipid accumulation in the aorta and IMT were not significantly reduced and no impairment of vasoreactivity or increase of pro-oxidant parameters were detected in New Zealand White rabbits after either a standard or a high-cholesterol diet Lorenz et al.

Although lycopene suppressed cholesterol uptake and intestinal absorption and increased fecal cholesterol excretion in rabbits, it did not decrease the expression of HMG-CoA reductase Lorenz et al. Hu et al. reported anti-atherosclerotic effects for both lycopene and fluvastatin, in the aorta, in rabbits, after a high-fat diet Hu et al.

Verghese et al. also revealed a significant decrease in the atherosclerotic plaque formation with the consumption of lycopene in a study including New Zealand male rabbits, receiving a high cholesterol diet.

Further observed effects include an improved serum lipid profile as well as reduction in total cholesterol, LDL and triglycerides Verghese et al. Watanabe Heritable Hyperlipidemic rabbits were used in a study by Frederiksen et al. demonstrating that lycopene did not influence cholesterol and triacylglycerol levels, lipoprotein fractions, oxidation of lipids, and aortic atherosclerosis evaluated biochemically and by microscopy Frederiksen et al.

The lack of response of lycopene in Watanabe Heritable Hyperlipidemic rabbits is, probably, related to their defective LDL receptors Tanazawa et al.

Considering the bloodstream transport of lycopene in LDL particles, functional LDL receptors enable cardiovascular benefits of lycopene Lorenz et al. Bansal et al.

reported a beneficial cardioprotective effect of lycopene, due to the reduction of oxidative stress and myocardial injury, in an experimental model of myocardial ischemia-reperfusion injury in adult male albino Wistar rats Bansal et al.

Lycopene protects also endothelial progenitor cells, necessary to replace the injured vascular endothelium and for angiogenesis, in a microenvironment of advanced glycation end products AGEs , which act as damage-causing agents Zeng et al. Lycopene improved cell proliferation and regulated protective mechanisms of AGEs-induced autophagy in endothelial progenitor cells from diabetic rats, suggesting that supplementation with this compound might be a new therapeutic option for diabetic vascular complications Zeng et al.

Both cross-sectional and supplementation studies emphasized the benefits of tomato products on vascular function, mainly due to the antioxidative effects of lycopene Kim et al. However, several articles failed to show improvement of endothelial function after tomato consumption Stangl et al.

Gajendragadkar et al. concluded that lycopene supplementation can improve endothelial function in patients with cardiovascular disorders, but not in age-matched healthy volunteers Gajendragadkar et al. Endothelial function was improved regardless of traditional risk factors or inflammatory markers, and, even a modest increase in serum lycopene, further impaired endothelial function in atherosclerotic patients Gajendragadkar et al.

One conclusion of the mentioned study was that lycopene affects especially smaller vessels, such as resistance arteries, rather than larger vessels, as measured arterial stiffness remained unaltered in all study participants Gajendragadkar et al.

Kim et al. reported an independent, inverse association between circulating lycopene and brachial pulse wave velocity in healthy women, regardless of age, body mass index, smoking and drinking habits, menopause, blood pressure, beta-carotene, alpha-tocopherol, markers of oxidative stress, and inflammation Kim et al.

Reduced oxidative LDL changes may have an important contribution to arterial stiffness reduction due to lycopene Kim et al.

Another study, including healthy men revealed the benefits of lycopene on oxidative stress and endothelial dysfunction, especially in subjects with an impaired endothelial function Kim et al. reported a decrease of systolic blood pressure and high sensitivity C reactive protein Kim et al.

The main biological mechanism by which lycopene reduces the risk and mortality of the metabolic syndrome , include the antioxidant, anti-inflammatory and antiobesity effects, the ability to improve endothelial function, glycemic control, insulin sensitivity and lipid profile Tsitsimpikou et al.

An inverse relationship was found by Yeo et al. between lycopene level and brachial-ankle pulse wave velocity Yeo et al. Higher serum carotenoid levels were associated not just with a lower prevalence of the metabolic syndrome, but also with fewer abnormal metabolic syndrome components.

A significant association between lycopene and the metabolic syndrome was described only for normal-weight and overweight participants, but not in obese patients, according to a study enrolling 13, subjects, probably related to an increased oxidative stress and decreased antioxidant ability, due to sequestration of lycopene in the adipose tissue and more important inflammation in obese Han et al.

On the other hand, daily tomato juice intake reduced waist circumference, cholesterol, and monocyte chemotactic protein-1 inflammatory adipokine and increased adiponectin anti-inflammatory adipokine levels in 30 young, healthy Taiwanese females Li et al.

Lycopene was shown to impair pro-inflammatory cytokine production, such as IL-6, IL-1b, and TNF-α, preventing insulin resistance Gouranton et al. A large study, including middle-aged, overweight volunteers reported no changes of conventional cardiovascular risk factors, inflammatory tests, insulin resistance and sensitivity, lipid profile, oxidized LDL, von Willebrand factor, and arterial stiffness after high daily intake of lycopene, despite good compliance Thies et al.

Several studies reported an association between serum lycopene levels and intima-media thickness Gianetti et al. Zou et al. revealed a decrease in carotid artery intima-media thickness IMT after 12 months of lutein and lycopene supplementation 20 mg each in Chinese patients with subclinical atherosclerosis, demonstrating more effective results after the intake of both lutein and lycopene compared to lutein alone Zou et al.

High serum levels of lycopene, alpha and beta-carotene were associated with a slow IMT progression during 7 years in a study including middle-aged men from Eastern Finland Karppi et al.

The association between lycopene level and IMT was mentioned in the scientific literature also for elderly Finish subjects Karppi et al. Higher carotenoids levels lutein, zeaxanthin, and beta-cryptoxanthin; Figure 1 were correlated with reduced IMT progression over 18 months, in a study with middle-aged participants, free of cardiovascular symptoms at baseline.

Beta-carotene and lycopene levels were not significantly associated with IMT progression Dwyer et al. An inverse correlation was found in women between lycopene levels and IMT, independent of conventional risk factors, in a large study including 1, subjects McQuillan et al.

Several studies revealed the anti-atherosclerotic effect of lycopene McQuillan et al. The possible reasons for this obvious discrepancy are manifold and include methodological differences in the study designs, such as different lycopene sources, the use of food-frequency questionnaires, different intervention times, the methodology used to assess vascular function, measurement of blood, adipose or dietary lycopene.

Besides those, the use of unstandardized amounts of tomato food products, different modes of delivery, misclassification of overall tomato intake, combination of lycopene with other antioxidants, different processing procedures or eating behavior influenced by cultural and temporal patterns among different individuals, may influence the results Sesso et al.

Other carotenoids extracted from tomatoes could be also partially responsible for the effects attributed to lycopene Rao, This is underlined by a study that could not find beneficial effects for lycopene supplementation alone, but beneficial effects upon supplementation with tomato-based products Sesso et al.

Some studies did not consider dietary intake at all Yeo et al. The interaction flavanone metabolites—lycopene is difficult to assess, considering the rapid metabolization of the mentioned metabolites Habauzit et al. Duration of treatment, dose and bioavailability of lycopene, and vascular endpoint were also different in the studies published on this topic and might have influenced obtained results.

Several factors influence the bioavailability of lycopene, such as season, the processing of tomatoes, their origin, dimensions, shape, and the way they are consumed Gajendragadkar et al. Absorption of lycopene may be reduced by diets rich in fibers and in elderly people Kong et al.

The isomerization of lycopene is another source of variability. Fresh tomatoes contain lycopene in all-trans form Shi and Le Maguer, Several factors, including high temperatures, light, oxygen, acids, and metal ions enable isomerization of lycopene Kong et al.

Lycopene degradation occurs during thermal processing, mainly isomerization of all- trans to cis forms and oxidation Shi and Le Maguer, Dehydrated and powdered tomatoes have poor lycopene stability, depending of storage in a hermetically sealed atmosphere, and a significant increase of cis-isomers, giving the highest bioavailability of lycopene and higher ability to be incorporated in lipoproteins Shi and Le Maguer, ; Kong et al.

Uptake of cis lycopene is significantly higher than all trans-isomers Kong et al. Lycopene is very bioavailable in the presence of oil, especially in monounsaturated oils, other dietary fats and processed tomato products Shi and Le Maguer, ; Basu and Imrhan, ; Kong et al.

Lycopene can increase the antioxidant properties of vitamin C, E, polyphenols and beta-carotene in a synergistic way Kong et al. Supplementation with tomatoes, containing lycopene red tomatoes or not yellow tomatoes , showed a better antioxidant effect than lycopene alone, probably due to the synergistic effects of naturally occurring secondary metabolites in tomatoes Basu and Imrhan, ; Gitenay et al.

Grapefruits also include in their composition not just lycopene but also flavonoids, with several benefits, such as the anti-inflammatory and anti-atherogenic effect, improving vascular reactivity, reducing insulin resistance, decreasing arterial stiffness, LDL cholesterol, and blood pressure Habauzit et al.

These synergistic effects hamper assessment of quantitative and qualitative effects of lycopene as a dietary factor. Several studies included healthy participants or subjects with different disorders and cardiovascular risk factors Kong et al.

Enrolling volunteers with established elevated risk markers for cardiovascular disorders may increase the probability of detecting changes, especially in short time studies Thies et al.

Also, several other uncontrolled or unidentified lifestyle factors or dietary constituents associated with cardiovascular disorders, may provide alternative explanations for the different study results Sesso et al.

Genetic factors remain unconsidered at all in all of the reviewed publications, although they are reported to strongly influence circulating concentrations of lycopene in different ethnicities Zubair et al.

Furthermore, plasma, adipose, and dietary carotenoids are not sufficiently correlated to be interchangeably Sesso et al. Most of the studies considered only tomatoes and tomato products as lycopene source.

It will be the aim of future human intervention studies to include other lycopene containing fruits such as watermelon, papaya, red grapefruits, and guava, and consider synergistic effects with other components and their importance in primary and secondary cardiovascular prophylaxis.

Benefits of lycopene should be especially considered in patients with high cardiovascular risk, statin intolerance, borderline hypertension, aspirin resistance, hyperactive platelets, vascular inflammatory diseases, metabolic syndrome and coronary heart disease, and its inclusion in combination therapies for the mentioned disorders, should be approached.

Further mechanistic research is needed to identify new targets for prevention and complementary treatment of cardiovascular disorders. The present review supports the importance of lycopene in improving vascular function and in the primary and secondary prevention of cardiovascular disorders.

The demonstrated effects of lycopene in view of cardiovascular health comprise its general antioxidant and anti-inflammatory abilities, the antiplatelet, anti-apoptotic and antihypertensive properties, the ability to improve endothelial function, the metabolic profile and ventricular remodeling, reduction of arterial stiffness as well as reduction of size of atherosclerotic plaque.

Lycopene exerts favorable effects in patients with subclinical atherosclerosis, metabolic syndrome, hypertension, peripheral vascular disease, and several other cardiovascular disorders, but sometimes conflicting results were obtained. Clearly, more and better-designed studies will be necessary to improve our understanding of the positive effects of lycopene on vascular health and to elucidate the involved mechanisms on a molecular level.

Future cardiovascular disease prevention strategies might include lycopene-enriched products, lycopene supplementation and new combinations including lycopene. Future studies focused on dietary lycopene and its synergistic effects with other dietary components in different study populations, with elevated cardiovascular risk, are highly warranted and might enable development of functional foods useful in prevention and complementary treatment of cardiovascular disorders.

IM is the author of the first draft of the manuscript. DS, AC, CM, JH, and AA contributed toward revising the paper and agree to be accountable for all aspects of the work. All authors agreed on the finally submitted version of the manuscript.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The authors acknowledge the support by the Polish KNOW Leading National Research Centre Scientific Consortium Healthy Animal—Safe Food, decision of Ministry of Science and Higher Education No.

Abdel-Daim, M. Lycopene attenuates tulathromycin and diclofenac sodium-induced cardiotoxicity in mice. doi: PubMed Abstract CrossRef Full Text Google Scholar. Abushouk, A. Cardioprotective mechanisms of phytochemicals against doxorubicin-induced cardiotoxicity.

Agarwal, S. In the study, 20 male and female runners between the ages of 22 and 54 were randomized to receive either the tomato complex or placebo for four weeks. At the end of four weeks, subjects were then subjected to a two-hour run.

Blood samples and delayed onset muscle soreness ratings were taken prior to and after the four weeks of supplementation, and then immediately after the two-hour run, then one, 24, and 48 hours after the run. There was then a crossover period following a two-week wash-out period in which the placebo group switched to receiving the tomato complex and the treatment group received placebo.

Results showed that while markers of inflammation, oxidative stress, and ratings of muscle soreness did not differ significantly between the treatment and placebo group post-exercise, levels of serum myoglobin were significantly different between the groups, with lower levels in subjects who took the tomato complex post-exercise.

The researchers explain that myoglobin is an iron- and oxygen-binding protein found in muscle tissue that is translocated to the blood compartment following acute muscle injury from intense exercise, making it a sensitive marker for muscle injury.

These promising initial results are an important step, opening the door for additional studies to further explore the role of carotenoids and tomato phytonutrients in complementing an active lifestyle and allowing people to optimize the benefits of exercise.

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