Lycopene in the Prevention of Cardiovascular Diseases 

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, accounting for approximately 17.9 million deaths annually, according to the World Health Organization (WHO) (WHO, 2021). The increasing prevalence of CVDs has prompted extensive research into preventive strategies, including dietary interventions. Among the various dietary components studied, lycopene, a potent antioxidant found predominantly in tomatoes and other red fruits, has garnered significant attention for its potential role in reducing the risk of cardiovascular diseases.  

What is Lycopene? 

Lycopene is a carotenoid, a class of naturally occurring pigments responsible for the red, orange, and yellow colors of many fruits and vegetables. Unlike some other carotenoids, such as beta-carotene, lycopene does not possess vitamin A activity. However, it is a powerful antioxidant, capable of neutralizing free radicals and reducing oxidative stress, a key contributor to the development of chronic diseases, including CVDs. 

Tomatoes and tomato-based products, such as tomato sauce, paste, juice and tomato extract are the richest dietary sources of lycopene. Other sources include watermelon, pink grapefruit, guava, and papaya. 

Mechanisms of Lycopene in Cardiovascular Disease Prevention 

Lycopene’s potential to prevent CVDs is attributed to its antioxidant, anti-inflammatory, and lipid-lowering properties. Below are the key mechanisms through which lycopene may exert its cardioprotective effects: 

1. Antioxidant Activity: Oxidative stress, resulting from an imbalance between free radicals and antioxidants, plays a central role in the pathogenesis of atherosclerosis, hypertension, and other cardiovascular conditions. Lycopene’s strong antioxidant capacity helps neutralize reactive oxygen species (ROS) and reduce oxidative damage to lipids, proteins, and DNA. 
2. Anti-Inflammatory Effects: Chronic inflammation is a hallmark of atherosclerosis and other CVDs. Lycopene has been shown to inhibit the production of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), and reduce the expression of adhesion molecules involved in the inflammatory response. 
3. Lipid-Lowering Effects: Lycopene has been associated with improvements in lipid profiles, including reductions in low-density lipoprotein cholesterol (LDL-C) and increases in high-density lipoprotein cholesterol (HDL-C). These effects are thought to be mediated by lycopene’s ability to inhibit the oxidation of LDL-C, a critical step in the development of atherosclerosis. 
4. Endothelial Function Improvement: The endothelium, the inner lining of blood vessels, plays a crucial role in regulating vascular tone and blood flow. Lycopene has been shown to enhance endothelial function by increasing the availability of nitric oxide (NO), a molecule that promotes vasodilation and reduces blood pressure. 
5. Antiplatelet Activity: Lycopene may also inhibit platelet aggregation, reducing the risk of thrombus formation and subsequent cardiovascular events, such as heart attacks and strokes. 

Epidemiological Evidence 

Numerous epidemiological studies have investigated the relationship between lycopene intake and cardiovascular disease risk. A meta-analysis of 21 prospective studies found that higher dietary intake of lycopene was associated with a 14% reduction in the risk of CVDs. Similarly, a large cohort study involving over 39,000 women found that higher plasma levels of lycopene were associated with a significantly lower risk of coronary heart disease. 

In addition to dietary intake, studies have also examined the relationship between serum lycopene levels and cardiovascular outcomes. A study published in the American Journal of Clinical Nutrition found that individuals with the highest serum lycopene levels had a 39% lower risk of stroke compared to those with the lowest levels. These findings suggest that lycopene may play a protective role against both coronary heart disease and stroke. 

Clinical Trials 

While epidemiological studies provide valuable insights, clinical trials are essential for establishing causality. Several randomized controlled trials (RCTs) have investigated the effects of lycopene supplementation on cardiovascular risk factors. 

1. Blood Pressure: This meta-analysis of 10 RCTs with 688 participants found that lycopene supplementation significantly reduced systolic blood pressure (SBP) by 2.63 mmHg, especially in hypertensive individuals. While diastolic blood pressure (DBP) reduction was not significant overall, it improved in subjects with elevated DBP. Findings suggest lycopene may benefit blood pressure regulation in hypertensive patients. 
2. Lipid Profile: The meta-analysis by Ried and Fakler (2011) reviewed 12 studies  on cholesterol and 4 studies on blood pressure, covering intervention trials from 1955 to 2010. The trials lasted a minimum of 2 weeks. Lycopene supplementation significantly reduced LDL cholesterol (~10%) and systolic blood pressure. However, lower doses had no significant effects, requiring further research for validation. 
3. Inflammation and Oxidative Stress: A randomized controlled trial included 126 healthy men who received either 6 mg, 15 mg lycopene, or a placebo daily for 8 weeks. The 15 mg group showed improved endothelial function, reduced oxidative stress, and lower inflammation markers. Lycopene also increased superoxide dismutase (SOD) activity and improved LDL particle size. The benefits were most pronounced in those with initially poor endothelial function. These findings suggest lycopene may enhance vascular health by reducing oxidative stress and inflammation, but further research is needed to confirm its long-term cardiovascular effects. 

Public Health Implications 

Given the growing burden of CVDs, there is a pressing need for effective preventive strategies. Lycopene, as a naturally occurring compound with multiple cardioprotective properties, holds promise as a dietary intervention. However, more research is needed to determine the optimal dosage, duration, and form of lycopene supplementation for cardiovascular health. 

Public health initiatives should focus on promoting the consumption of lycopene-rich foods, such as tomatoes and tomato-based products, as part of a balanced diet. Educational campaigns can raise awareness about the health benefits of lycopene and encourage individuals to incorporate these foods into their daily diets. 

Lycopene, a potent antioxidant found in tomatoes and other red fruits, has emerged as a promising dietary component for the prevention of cardiovascular diseases. Its antioxidant, anti-inflammatory, lipid-lowering, and endothelial-protective properties make it a valuable tool in the fight against CVDs. While epidemiological and clinical studies provide compelling evidence of lycopene’s cardioprotective effects, further research is needed to establish definitive recommendations for its use in cardiovascular disease prevention. In the meantime, increasing the consumption of lycopene-rich foods can be a simple and effective strategy for promoting heart health. 

Disclaimer: The Statement has not been evaluated by the EFSA, KFDA or FDA. This product is not intended to diagnose, treat, cure, or prevent any disease. While the information provided is based on credible references, we do not make any specific claims or guarantees. It is important to consult with your healthcare advisor for personalized advice and guidance related to your health.  

References: 

• Agarwal, S., & Rao, A. V. (2000). Tomato lycopene and its role in human health and chronic diseases. Canadian Medical Association Journal, 163(6), 739-744. 
• Cheng, H. M., Koutsidis, G., Lodge, J. K., Ashor, A., Siervo, M., & Lara, J. (2017). Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis. Atherosclerosis, 257, 100-108. 
• Inhibitory effects of lycopene on in vitro platelet activation and in vivo prevention of thrombus formation 
• Fuhrman, B., Elis, A., & Aviram, M. (1997). Hypocholesterolemic effect of lycopene and β-carotene is related to suppression of cholesterol synthesis and augmentation of LDL receptor activity in macrophages. Biochemical and Biophysical Research Communications, 233(3), 658-662. 
• Gajendragadkar, P. R., Hubsch, A., Maki-Petaja, K. M., Serg, M., Wilkinson, I. B., & Cheriyan, J. (2014). Effects of oral lycopene supplementation on vascular function in patients with cardiovascular disease and healthy volunteers: A randomised controlled trial. Journal of Nutrition, 144(5), 654-660.  
• Gärtner, C., Stahl, W., & Sies, H. (1997). Lycopene is more bioavailable from tomato paste than from fresh tomatoes. American Journal of Clinical Nutrition, 66(1), 116-122. 
• Karppi, J., Laukkanen, J. A., Sivenius, J., Ronkainen, K., & Kurl, S. (2012). Serum lycopene decreases the risk of stroke in men: A population-based follow-up study. Neurology, 79(15), 1540-1547.  
• Kim, J. Y., Paik, J. K., Kim, O. Y., Park, H. W., Lee, J. H., Jang, Y., & Lee, J. H. (2011). Effects of lycopene supplementation on oxidative stress and markers of endothelial function in healthy men. Atherosclerosis, 215(1), 189-195. 
• Lycopene in the Prevention of Cardiovascular Diseases 
• Palozza, P., Catalano, A., Simone, R. E., Mele, M. C., & Cittadini, A. (2011). Effect of lycopene and tomato products on cholesterol metabolism. Annals of Nutrition and Metabolism, 59(2-4), 127-134. 
• Rao, A. V., & Agarwal, S. (1999). Role of antioxidant lycopene in cancer and heart disease. Journal of the American College of Nutrition, 18(5), 563-569. 
• Ried, K., & Fakler, P. (2011). Protective effect of lycopene on serum cholesterol and blood pressure: Meta-analyses of intervention trials. Maturitas, 68(4), 299-310.  
• Sesso, H. D., Buring, J. E., Norkus, E. P., & Gaziano, J. M. (2003). Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in women. American Journal of Clinical Nutrition, 79(1), 47-53.  
• Sesso, H. D., Buring, J. E., Norkus, E. P., & Gaziano, J. M. (2012). Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in men. American Journal of Clinical Nutrition, 96(1), 46-52.  
• World Health Organization (WHO). (2021). Cardiovascular diseases (CVDs).  
• Lycopene Supplementation and Blood Pressure: Systematic review and meta-analyses of randomized trials