As if chianti, pizza and Gucci were not enough reasons to love everything Italian, one of the most powerful natural therapies for common cardiovascular conditions has Italian roots, literally. Rather than the sangiovese grape, I am talking about the bergamot. Bergamot may sound familiar as the peel of this citrus that looks like a lemon is often used for teas, perfumes, and essential oils. The citrus grows on a tree only in the region of Southern Italy called Calabria, very close to Sicily. Beyond the appeal of the peel, the fruit pulp itself has a unique combination of flavonoid chemicals that are a mouthful. Although the names are unfamiliar, like naringin, bruteridin, and melitidin, these natural bergamot compounds block the same enzyme that statin medications like Lipitor block without the concern over Lipitor side effects. Bergamot has also been shown to lower blood sugar, lower inflammation, improve blood vessel activity, and activate the AMPK system similar to a popular diabetic drug called metformin.

How is all of this known about the citrus fruit growing in a remote zone of Italy? There was a tradition that natives that ate the fruit of the bergamot citrus did not get heart disease, diabetes and other maladies. Universities in that region began studying this folklore and it proved to be an accurate local legend. There are now more than 200 scientific studies in animals and humans exploring the role of bergamot for health. Bergamot is available by tablet or capsule in a format that concentrates the active polyphenols found in the whole fruit.

Does bergamot work in patients? The science says yes and my experience does too. In a recent trial in 77 patients with high cholesterol, subjects were treated with a statin medication alone or combined with bergamot. The combination therapy produced the lowest LDL cholesterol and the highest HDL cholesterol. In addition, measures of damage to blood vessels by oxidation were the lowest with when bergamot was added. In other studies, the beneficial effects of bergamot on blood sugar levels and body weight were demonstrated.

Have you heard of the metabolic syndrome? An estimated 20–25% of the world’s adult population is judged to have this condition and maybe as many as 1/3rd of adults in the United States, tens of millions of people, suffer from it. It is a combination of increased abdominal fat and waistline, hypertension, abnormal cholesterol lipid values with low HDL and high triglycerides, elevated blood sugar. Bergamot has proven to particularly useful in assisting the reversal of this syndrome which raises the risk of future events like heart attack and stroke.

A particularly vexing problem seen more and more commonly is non-alcoholic fatty liver disease (NAFLD), also known as NASH. NASH results from inactive lifestyles along with diets high in processed foods stuffed with oils and fats and overloads liver cells with fat droplets. It is also associated with insulin resistance, pre-diabetes and adult Type 2 diabetes as the insulin resistance builds. While the foundation of the treatment of NASH is activity, weight loss, and plant based diets low or absent added oils, bergamot shows promise here too. In a study using an animal model, bergamot reduced liver stores of fat by a large amount over placebo and facilitated the recovery from this serious condition. In another study in humans with metabolic syndrome and NAFLD, significant responses to bergamot were seen.

I enjoy practicing cardiology more than ever because the “toolbox” I was taught to treat patients in medical school and beyond has expanded to emphasize personalized lifestyle medicine and nutraceuticals. We live in a society that favors sedentary lifestyles and processed foods that put all of us at risk for obesity, diabetes, elevated cholesterol and heart disease. More and more safe and effective strategies, like bergamot, are needed.

Why have you likely never heard of bergamot? It is a natural product and therefore hard to patent and charge high prices to offset the costs of a FDA approval process. If a prescription drug derived from a plant was not only safe but supported a lower blood sugar, blood pressure, blood cholesterol while simultaneously promoted reversal of the metabolic syndrome, and NAFLD (while also showing promise in erectile dysfunction and chemotherapy related cardiac toxicity) it would surely be a billion dollar sales success. Since I started using this plant-based “vitamin B’” with my patients, I have seen many people experience better health and bergamot related reversal of disease conditions. Combined with lifestyle efforts focusing on diet, exercise, sleep and stress, maybe someone you know can benefit from the marvel from southern Italy called bergamot.