Bergamot: A Botanical Alternative for Cardiovascular Health

Long used in culinary and cosmetic realms, the bergamot plant offers numerous powerful cardiovascular health benefits, too, according to recent research. Bergamot (Citrus bergamia), known largely as the citrusy, floral flavoring in Earl Grey tea, is a delicate fruiting plant native to the Calabrian region of southern Italy. An array of personal care products contain bergamot essential oil, said to possess both calming and uplifting properties. Mounting evidence adds cholesterol-balancing and cardioprotective qualities to the plant's list of healing traits.

BergamotResearchers have identified a unique profile of health-enhancing flavonoids and glycosides in the juice and the tissues of bergamot, which is distinguished from other citrus fruits not only by the unusual composition of its flavonoids, but also their particularly high content. Teams studying these compounds have found that they positively impact blood pressure and blood lipid levels.

The buzz around bergamot research caught the attention of US supplement maker Ortho Molecular Products, which launched a new Bergamot Bioactive Polyphenolic Fractions (BPF) product in December 2016.

Ortho Molecular Brand Manager Jonathan Cannizzo, MSc., pointed to a groundbreaking study comparing the lipid-lowering effects of bergamot BPF to the widely used statin drug, rosuvastatin. Published in 2013 in the International Journal of Cardiology, the study looked at whether supplementation with bergamot-derived polyphenols would produce a dose-sparing effect in high-risk cardiovascular patients taking statins, while still achieving target lipid values.

The study, led by researchers at the Center for Food Safety & Health at Magna Graecia University, Catanzaro, Italy, involved 77 patients with elevated LDL and triglycerides. They were randomly assigned to a control group receiving placebo (n=15), two groups receiving orally administered rosuvastatin (10 and 20mg/daily for 30 days; n=16 for each group), a group receiving BPF alone orally (1,000 mg/daily for 30 days; n=15), and a group receiving BPF (1,000 mg/daily given orally) plus rosuvastatin (10mg/daily for 30 days; n=15).

When compared to control group, both doses of rosuvastatin and BPF reduced total cholesterol, LDL-C, the LDL-C/HDL-C ratio, and urinary mevalonate. There were also reductions in biomarkers of oxidative vascular damage such malondialdehyde, oxyLDL receptor LOX-1, and phosphoPKB.

Adding BPF to the statin regimens significantly enhanced the drug's effects on lipid profiles. Bergamot's lipid-lowering power was "associated with significant reductions of biomarkers used for detecting oxidative vascular damage, suggesting a multi-action enhanced potential for BPF in patients on statin therapy," they wrote (Gliozzi, M. et al. Int J Cardiol. 2013; 170(2): 140-145).

In addition to its cholesterol-lowering effects, "bergamot acts as an anti-inflammatory," Cannizzo explained, providing "general benefits for cardiovascular health and attacking some of the risk-associated biomarkers with cardiovascular challenges or cardiovascular disease."

These inlcude: LDL particle size, blood glucose, triglycerides, and C-reactive protein."

Lipid Lowering Effects

Gliozzi's findings echo a 2011 study, also done at Magna Graecia 2011, looing at the effects of  BPF in 237 patients with hyperlipidemia. The investigators wondered whether bergamot extract could function as a natural, side effect-free treatment for high cholesterol -- and their results show that, for the right patients, it can.

Patients were divided into three groups:

  • Group A (N=104): Subjects with isolated hypercholesterolemia (HC) (cLDL levels ≥130 mg/dl);
  • Group B (N= 42): Subjects had hyperlipidemia (hypercholesterolemia and hypertryglyceridemia;
  • Group C (N= 59): Subjects had metabolic syndrome patients  mixed hyperlipidemia and glycemia

Each group was further divided into three subgroups. The first received an oral dose of BPF (500 mg/day; A1, B1, and C1); the second got 1,000 mg/day of BPF (A2, B2, and C2) and the third received placebo (APL, BPL, and CPL).

A final "post-statin" group comprised 32 patients who had stopped statin therapy due to muscular pain and a significant elevation of serum creatine phosphokinase. They received 1,500 mg/day of BPF daily, after a washout period of 60 days.

The investigators found that BPF, taken orally for 30 days, could total and LDL cholesterol and triglycerides, while also significantly decreasing participants’ blood glucose.

In particular, the 59 metabolic syndrome patients in group C responded well to BPF therapy. Their mean baseline lipid profiles changed markedly: total cholesterol dropped from 278 mg/ml to 199, LDL webt from 188 mg/ml to 126; and triglycerides went from 267 mg/ml to 158 mg/ml. 

The LDL reductions were accompanied by a dose-dependent elevation in HDL (cHDL) in all patients. In the 10% of patients with the strongest responses to bergamot, HDL jumped a massive 64.6%. Additionally, metabolic syndrome patients showed a highly significant (P<0.0001) drop in blood glucose levels (a mean reduction of −18.9% in those taking 500 mg BPF, and a −22.4% decrease in those on 1,000 mg of bergamot.

The bergamot extract also inhibited the activity of HMG-CoA reductase -- the rate-limiting enzyme for cholesterol synthesis -- and enhanced participants' reactive vasodilation. Prof. Vincenzo Mollace and his colleagues concluded that bergamot represents, "an efficient phytotherapeutic approach" to combating hyperlipidemic and hyperglycemic disorders (Mollace, V. et al. Fitoterapia. 2011; 82(3): 309-316). 

More recently, the Magna Graecia group, working collaboratively with researchers at the University of Roma, looked at 107 patients with metabolic syndrome and non-alcoholic fatty liver disease (NAFLD), confirmed by ultrasound. Patients were divided into two groups, one receiving placebo and the second getting BPF, 650 mg, twice a day for 120 consecutive days.

The BPF-treated group showed a significant reduction in fasting plasma glucose, serum LDL, and TGL, accompanied by an increase in HDL. They also showed reductions in ultrasonographic and metabolic biomarkers of NAFLD, and a decrease of small dense LDL particles, as detected via proton NMR Spectroscopy (Gliozzi, M. et al. Adv Biol Chem. 2014; 4(2): 129-137). 

With heart disease claiming the lives of more than half a million Americans each year, optimizing cardiovascular wellness is a top priority for many physicians.

"There is going to be a time for pharmaceutical interventions," Ortho Molecular's Cannizzo said. "But bergamot provides clinicians with a natural solution to cholesterol support." Part of what makes the plant so unique, he explained, is the option to use it either in conjunction with statin therapy to keep drug doses as low as possible, or as a standalone alternative to statins, for some patients.

Cannizzo says Ortho Molecular is sourcing its bergamot material directly from the Italian group that did the pioneering clinical research, and holds an exclusive contract to sell that this specific extract in a practitioner channel.

With few side effects and a wide range of heart health benefits, bergamot deserves a spot in our medicine chests as well as in our tea cabinets.

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