Effect of the peels of two Citrus fruits on endothelium function in adolescents with excess weight: A triple-masked randomized trial

Background: Obesity induces endothelial dysfunction even in the pediatric age group. Th e possible protective eff ects of fruits and herbal products on the endothelial dysfunction of obese children remain to be determined. Th is study aims to investigate the eff ects of lemon and sour orange peels on endothelial function of adolescents with excess weight. Materials and Methods: Th is triple-masked, randomized placebo-controlled trial was conducted for 1-month among 90 overweight and obese participants, aged 6-18 years. Th ey were randomly assigned into three groups of equal number receiving daily oral capsules containing lemon or sour orange powder or placebo. Flow-mediated dilatation (FMD) was compared between three groups by using analysis of covariance. Results: Overall, 30 participants in the lemon group, 27 in the sour orange group and 29 in the control group completed the trial. After the trial, mean FMD was signifi cantly (P < 0.001) higher in the lemon group (11.99 ± 4.05) and in the sour orange group (12.79 ± 5.47) than in the placebo group (6.45 ± 2.79). FMD percent change was 145.02 ± 24.34 in the lemon group, 142.04 ± 16.11 in the sour orange group, and 46.73 ± 5.16 in controls (P < 0.001). Conclusion: Th is trial showed that consumption of extracts of lemon and sour orange peels, which contain plenty amounts of antioxidants, fl avonoids, pectin, and vitamin C, might have signifi cant benefi ts on endothelial function in children and adolescents with excess weight. Trial registry code: IRCT201311201434N10.