Clinical effects of Hibiscus sabdariffa Linn. on obesity treatment: A systematic review and meta-analysis of randomized controlled trials

Abstract

IntroductionObesity is associated with many chronic non-communicable diseases, including hypertension, diabetes, cardiovascular and cerebrovascular diseases, cancer, gallbladder disease, bone and joint disorders, skin diseases, fatty liver disease, etc. (Wharton et al., 2020)1 The recent report revealed that overweight and obesity were prevalent in 60 % of the adult population. Several studies have been published to determine the effect of Hibiscus sabdariffa Linn. on obesity treatment, but the findings are still inconclusive. The purpose of this study was to determine the efficacy and safety of H. sabdariffa Linn in the treatment of obesity. MethodsWe searched PubMed, EMBASE, and CENTRAL from inception to February 2024. Randomized controlled trials (RCTs) were included if they explored the effect of H. sabdariffa on one of the following outcomes: body weight, body mass index (BMI), waist circumference, and waist-to-hip ratio. A random-effects model was used to meta-analyze the data. I2 was used to quantify statistical heterogeneity among the included RCTs. PROSPERO registered protocol: CRD42023408880. ResultsA total of six RCTs with 339 participants were included. Four trials used H. sabdariffa extract in capsules as the intervention of interest compared to placebo, while the other two trials used H. sabdariffa tea compared to black or green tea. Our meta-analyses showed that the mean difference in weight reduction between H. sabdariffa and control was − 0.27 kg (95 % confidence interval (CI); − 1.98 to 1.42, I2 = 0.0 %). The mean differences for BMI and waist circumference reduction were − 0.06 kg/m2 (95 % CI; − 0.58 to 0.47, I2 = 0.0 %) and − 0.20 centimeters (95 % CI; − 2.06 to 1.66, I2 = 0.00 %). No safety concerns were reported in the included studies. ConclusionOur study did not show a clinical benefit of H. sabdariffa extract in obesity treatment. However, further high-quality RCTs with a longer treatment duration and a standard dose are still warranted.