Does Nigella sativa supplementation improve cardiovascular disease risk factors? A comprehensive GRADE-assessed systematic review and dose-response meta-analysis of 82 randomized controlled trials.

Vali Musazadeh, Amir Hossein Faghfouri, Sahar Golabi, Mahshid Naghashpour, Ali Jafari, Helia Mardani, Zahra Mirzaei Fashtali, Mohtaram Hashemi, Matin Abdollahi Yousefabady, Reihane Javid, Bahareh Arghavan

Journal: Pharmacological research 2025;219():107882

PMID: 40714301

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Plain Language Summary

Cardiovascular disease (CVD) is one of the leading causes of illness and death worldwide. Many people look for natural supplements to help reduce risk factors such as high blood pressure, high cholesterol, and poor blood sugar control. Nigella sativa, also known as black seed, has traditionally been used in herbal medicine, but its overall effectiveness on heart and metabolic health has not been fully established.This systematic review and dose-response meta-analysis of 82 randomised controlled trials, examined whether different amounts of Nigella sativa supplementation improved health outcomes linked to cardiovascular disease, such as blood pressure and cholesterol levels.

The results showed that Nigella sativa supplementation led to small but significant improvements in several cardiometabolic risk factors. Improvements were observed in total cholesterol, low-density lipoprotein (LDL, “bad” cholesterol) cholesterol, triglycerides, fasting blood sugar, blood sugar control, and both systolic and diastolic blood pressure. Some effects were dose-dependent, meaning certain amounts produced stronger benefits. However, the certainty of evidence ranged from low to moderate for most outcomes, meaning that while results are promising, further high-quality research is still needed.

In conclusion, Nigella sativa (black seed) supplementation appears to offer modest benefits for several cardiovascular and metabolic risk factors. Healthcare professionals may consider it as a complementary strategy for improving cardiometabolic health, while recognising that it should not replace standard medical treatment and that evidence quality varies.

Abstract

AIM

This systematic review and meta-analysis aimed to evaluate the effects of Nigella sativa (N. sativa) supplementation on metabolic and cardiovascular health outcomes.

METHODS

A comprehensive search of EMBASE, Scopus, PubMed, CENTRAL, and Web of Science databases was conducted up to August 2024. Study quality and certainty of evidence were assessed using the Cochrane Risk of Bias and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tools, respectively.

RESULTS

Eighty-two studies, including 79 quantitative and 3 qualitative studies published between 2008 and 2024, involving 5026 participants with interventions ranging from 1 to 48 weeks and doses varying from 200 to 4600 mg/day, were included. N. sativa supplementation significantly improved body fat percentage (BF%), body mass index (BMI), skeletal muscle mass (SMM), waist circumference (WC), weight, waist-to-hip ratio (WHR), diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), fasting blood sugar (FBS), hemoglobin A1c (HbA1c), postprandial blood glucose (PPBG), quick insulin sensitivity check index (QUICKI), C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), intercellular adhesion molecule-1 (ICAM-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), vascular cell adhesion molecule-1 (VCAM-1), atherogenic index (AI), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) to HDL-C ratio, TC, triglycerides (TG), very-low-density lipoprotein cholesterol (VLDL-C), alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, urea, catalase (CAT), malondialdehyde (MDA), superoxide dismutase activity (SOD) activity, and total antioxidant capacity (TAC).

CONCLUSIONS

Our findings suggest that N. sativa could be a promising adjunct therapy for improving cardiovascular disease (CVD) risk factors.

Address: Student Research Committee, Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran. Electronic address: [email protected].; Student Research Committee, Department of Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.; Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.; Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran.; Student Research Committee, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.; Department of Medical Physiology, School of Medicine, Abadan University of Medical Science, Abadan, Iran.; Department of Laboratory Sciences, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran.; Student Research Committee, Iran University of Medical Sciences, Tehran, Iran. Electronic address: [email protected].; Department of Nutrition, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran. Electronic address: [email protected].

DOI: 10.1016/j.phrs.2025.107882