Summary: In overweight or obese adults without chronic illness, one week of American black elderberry juice produced a broader meal-responsive gene-expression profile than placebo, enriching insulin-related pathways, with no clinical metabolic endpoints measured.
PICO Summary
| Element | Detail |
|---|---|
| Population | Overweight or obese adults (BMI >25) without chronic illness; 10 had RNA sequencing performed. |
| Intervention | American black elderberry juice twice daily for one week (crossover). |
| Comparison | Placebo beverage for one week under identical conditions, with washout. |
| Outcome | 234 differentially expressed genes in the fasted-to-fed transition versus 59 for placebo; enrichment of insulin, FoxO and PI3K-Akt signalling; 27 KEGG pathways modulated versus 7. No clinical endpoints. Well tolerated. |
Expert Commentary
I will confess my first instinct with a single-food supplement study is wariness, because the field is littered with molecular findings dressed up as health benefits. This is a careful piece of nutrigenomics, and the transcriptomic signal is real enough, but I have to be blunt about what it is and is not. It measured gene expression after a meal in ten people over one week, and it did not measure glucose, insulin sensitivity, or weight, so it tells me elderberry juice changes how genes respond to food, not that it does anything I or my patient would feel. Differentially expressed genes and enriched KEGG pathways are several inferential steps away from clinical benefit. Can I use this with my patients? Not as a recommendation for anything. If a patient enjoys elderberry juice I have no objection, provided it is properly prepared, since raw elderberries are toxic, and provided they watch the sugar content of commercial products. But I would actively discourage anyone from treating it as a metabolic therapy. I would need a proper trial with clinical endpoints before this is more than an interesting molecular curiosity.
References
Teets C, Etter AJ, Solverson PM. One-week elderberry juice intervention promotes metabolic flexibility in the transcriptome of overweight adults during a meal challenge. Nutrients. 2025;17(19):3142. doi:10.3390/nu17193142