Effects of Moringa oleifera Lam. Supplementation on Cardiometabolic Outcomes: A Meta-Analysis of Randomized...

Background/Objectives:Moringa oleifera Lam. is traditionally used in African and Asian medicine for its nutritional and therapeutic properties. Rich in (poly)phenols, vitamins, and minerals, various parts of the plant were used to manage metabolic disorders. No systematic research critically evaluated its impact on cardiometabolic outcomes assessed through randomized controlled trials (RCTs), thus this study aimed to do so by synthesizing existing evidence. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted through 7 April 2025. Eligible RCTs with a minimum duration of two weeks that evaluated moringa supplementation in adults (≥18 years) and reported at least one cardiometabolic outcome, including anthropometric measures, lipid profile, glycemic indices, or blood pressure. Random-effects meta-analyses were performed using standardized mean differences, risk of bias was assessed using the Cochrane RoB 2 tool, while the certainty of evidence was evaluated using GRADE assessment. Results: Nine RCTs (12 study arms) involving 341 participants in the intervention and 308 in the control groups met inclusion criteria. Moringa supplementation showed no significant effects on most considered outcomes. A modest reduction in diastolic blood pressure (SMD: -0.41; 95% CI: -0.75 to -0.07; p = 0.02; I² = 19%) was observed; however, this effect was not robust in sensitivity analyses. Subgroup analyses suggested potential benefits at doses <10 g/day, in participants <50 years old, and in interventions lasting ≥12 weeks. Nevertheless, risk of bias, substantial heterogeneity (I² frequently >80% for anthropometric and lipid parameters), indirectness, and methodological limitations reduced the overall certainty of evidence to very low for all the evaluated outcomes. Conclusions: Current evidence does not support consistent cardiometabolic benefits of moringa supplementation in adults. Further large-scale, rigorously designed RCTs are warranted to clarify its therapeutic potential and optimal supplementation parameters.