Meta-analysisThe effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: A systematic review and meta-analysis of randomized clinical trials

•The cactus pear, Opuntia ficus-indica (OFI), is marketed under trade names such as Proactol and XLS medical, with “certified” claims of clinical efficacy in obesity management.•OFI-containing supplements are also being marketed as antidiabetic agents.•The results from our meta-analysis of published clinical trials do not indicate that OFI supplementation has significant beneficial effects on body weight.•Our results suggested that OFI intake causes significant reductions in body mass index, percentage body fat and total; however, the effect sizes are small and do not reach clinical significance.•Few clinical trials evaluating the effects of OFI in obesity management have been conducted; they vary in design and methodology.

ObjectivesHundreds of dietary supplements are currently marketed as weight loss supplements. However, the advertised health claims of effectiveness for most of these have not been proven. The aim of this study was to critically appraise and evaluate the evidence for effectiveness of cactus pear, Opuntia ficus-indica (OFI), using data from published randomized clinical trials.MethodsWe conducted electronic searches in Medline, Embase, Amed, Cinahl, and the Cochrane Library. No restrictions on age, time, or language were imposed. The risk for bias in the studies included was assessed using the Cochrane Collaboration criteria. Two reviewers independently determined the eligibility of included studies, assessed reporting quality, and extracted data.ResultsWe identified seven eligible studies, of which five were included. The studies varied in design and reporting quality. Meta-analysis revealed a nonsignificant difference in body weight between OFI and controls (mean difference = −0.83 kg; 95% confidence interval, −2.49 to 0.83; I2 = 93%). Significant reductions in body mass index, percentage body fat, systolic and diastolic blood pressures, and total cholesterol were observed. Adverse events included gastric intolerance and flu symptoms.ConclusionThe evidence from randomized clinical trials does not indicate that supplementation with OFI generates statistically significant effects on body weight. Consumption of OFI can cause significant reductions in percentage body fat, blood pressure, and total cholesterol. Few clinical trials evaluating the effects of OFI have been published. They vary in design and methodology, and are characterized by inconsistent quality of reporting. Further clinical trials evaluating the effects of OFI on body composition and metabolic parameters are warranted.