Journal of Plant Medicines: Tomatoes have Numerous Health Benefits

Tomatoes are known for their impressive array of health benefits along with their incredible flavor.

Here is a detailed look at the health benefits of tomatoes, their botany, primary compounds, traditional medicinal uses, and findings from recent human clinical research.

What are Tomatoes?

The tomato (Solanum lycopersicum) is a small, bushy plant that can grow up to 3 meters with support. It has soft, hairy stems and leaves that are oval-shaped, pinnately compound, and slightly hairy. The plant produces yellow flowers that develop into round or slightly oblong red fruits (tomatoes) when ripe, although certain cultivars yield tomatoes in yellow, orange, green, or even purple color.

Tomatoes are native to western South America and Central America. They thrive in warm climates with well-drained soil and plenty of sunlight. Today, they are cultivated globally, with China, India, and the United States being among the largest producers.

Primary Health Benefits

Rich in Antioxidants: Tomatoes are rich in antioxidants, especially lycopene, which is linked to various health benefits, including reduced risks of cancer and heart disease. Lycopene's high bioavailability in cooked tomatoes makes tomato-based sauces and stews an excellent source.

Heart Health: The potassium, fiber, vitamin C, and choline in tomatoes support cardiovascular health. Lycopene is known to improve lipid levels, and the fiber aids in lowering blood pressure, collectively helping reduce cardiovascular disease risk.

Skin Protection: Tomatoes’ antioxidants, particularly lycopene and beta-carotene, are linked to UV protection, potentially lowering the risk of sunburn and improving skin health.

Anti-Inflammatory Properties: Compounds such as lycopene and beta-carotene have shown anti-inflammatory effects, which can benefit conditions like arthritis and metabolic syndrome.

Eye Health: Tomatoes contain lutein, beta-carotene, and vitamin A, essential nutrients for eye health that may lower the risk of macular degeneration and cataracts.

Primary Bioactive Compounds

Lycopene: A powerful antioxidant responsible for the red pigment of tomatoes, lycopene is linked to heart health, cancer prevention, and skin protection.
Beta-Carotene: Converts into vitamin A in the body, supporting vision, immunity, and skin health.
Vitamin C: An antioxidant that supports immune function and skin health.
Potassium: Essential for cardiovascular health by helping regulate blood pressure.
Folate: Important for DNA synthesis and repair, making it essential for pregnant women.

Tomatoes contain hundreds of nutrients. Raw tomatoes are excellent or good sources of vitamin C, biotin, molybdenum, vitamin K, vitamin A, vitamin B6, folate, pantothenic acid, vitamin B3, vitamin B1, vitamin E, copper, potassium, manganese, phosphorus, magnesium, chromium, choline, zinc, iron and protein. One cupful of raw tomatoes will also contain over two grams of fiber.

Tomatoes also contain numerous phytocompounds. These include carotenoids such as lycopene, lutein, zeaxanthin, alpha- and beta-carotene; flavonols such as rutin, kaempferol and quercetin; flavonones such as naringenin and chalconaringenin; caffeic acid; ferulic acid; coumaric acid; esculeoside A; octadecadienoic acid and others.

Now a few of these compounds – those that are heat-sensitive – are depleted when tomatoes are cooked. However, there is significant evidence now pointing to the fact that cooking tomatoes makes many of tomatoes’ healthiest compounds more bioavailable to the body.

Traditional Medicinal Uses

Latin America: Historically, indigenous peoples of Central and South America used tomatoes for digestive ailments and considered them a cooling food that could treat heat-induced ailments.
Ayurveda: In Ayurvedic practices, tomatoes are used in moderation due to their potential to increase “pitta” or heat in the body. However, they are valued for their detoxifying effects and their ability to balance cholesterol.
Chinese Medicine: Tomatoes are seen as cooling foods that help alleviate inflammation, improve digestion, and clear toxins from the body. They are also used to treat symptoms of hypertension and liver issues.
Mediterranean and European Folk Medicine: Tomatoes have been used as diuretics, to aid digestion, and in some cases as a topical remedy for skin irritations and burns due to their antioxidant properties.

Research on Tomatoes

Research continues to investigate tomatoes’ numerous health benefits, especially in areas of cardiovascular health, cancer prevention, and metabolic health.

Prostate Cancer Risk

Lycopene has been shown in the research to reduce the risk of prostate cancer. A 2020 review of research found that lycopene significantly reduced prostate cancer risk, especially in populations with higher tomato consumption.

Tomatoes also help reduce prostate enlargement. A 2021 study from Italy tested patients with benign prostatic hyperplasia (BPH) for two months with five grams of a tomato food supplement.

After the test period those given the tomato supplement saw reduced scores compared to the placebo group.

Lycopene and Skin Health

Increased dietary intake of lycopene was linked to decreased sensitivity to UV-induced erythema (sunburn), suggesting skin protection benefits.

A German study tested nine people with 40 grams of tomato paste for ten weeks and compared them to 10 people who received an olive oil placebo. Both groups were then exposed to significant sunshine. The tomato paste group had 40 percent lower levels of sunburn compared to the placebo group.

A 2019 German study found that a tomato nutrient complex supplement helped protect people from UVA and UVB sunburns.

A 2022 study from Indonesia's Diponegoro University studied skin melasma in 62 people. Over a 12-week period, the researchers gave half of the people a 30-milligram lycopene supplement and the other half were controls. They researchers found the lycopene group had higher levels of superoxide dismutase levels compared to the control group.

The lycopene group also had significantly lower melasma scores (MASI) compared to the control group.

A 2023 study tested 62 people for three months. They were given a tomato-based supplement called Lumanato. The researchers found the group had significant improvement in their skin barriers, skin firmness and elasticity.

Diabetes and Obesity

Research has illustrated that tomatoes can help promote glycemic balance in the body. This relates directly to obesity and blood sugar regulation, helping to prevent diabetes.

Gum Health

A 2013 study tested 20 patients with mild to moderate gum disease. They were given lycopene supplements or a placebo. The lycopene group had significant improvement in their gum disease scores compared to the placebo group.

Anti-Inflammatory Effects

Tomato juice consumption has been shown to reduce inflammation in other studies.

Daily consumption of tomato juice was associated with reduced levels of inflammatory markers in overweight and obese women.

A 2022 study from Switzerland studied overweight and obese adults over a four-week period with six-week washout period. The researchers found that a tomato extract significantly reduced trimethylamine-n-oxide (TMAO) levels in the blood, and thus improved intestinal gut health. This is because TMAO harms our gut probiotics.

Eye Health

Eye nutrients from tomato include beta-carotene, zeaxanthin and lutein. These have been shown to reduce the risk of age-related macular degeneration according to studies.

Regular intake of tomatoes, high in beta-carotene, zeaxanthin and lutein, has been shown to slow progression of age-related macular degeneration.

Cardiovascular Health

Regular tomato consumption has been shown to improve lipid profiles, lower blood pressure, and reduce inflammation markers in participants with higher cardiovascular risk.

A 2021 study from Italy's University Magna Grecia studied 91 people who consumed a tomato sauce or yogurt for six weeks. After the period, the tomato group's lipid levels improved by 12 percent.

A 2019 study from Israel's Soroka University tested people with high blood pressure. They found that daily doses of 15 milligrams of lycopene or higher significantly reduced systolic blood pressure.

A large 2024 study followed 7,056 people with high blood pressure over a three-year period. They compared the people with 1,097 people who had normal blood pressure.

The researchers found that those who consumed higher levels of tomato products had significantly better blood pressure levels compared to those who consumed little or no tomato products.

Research has confirmed that lycopene, the carotenoid that makes tomatoes red, lowers the risk of hardening of the arteries.

A 2011 study from researchers at the San Camillo de Lellis Hospital Cardiology Unit in Foggia, Italy, used ultrasonic testing and blood tests to determine that those with higher blood levels of lycopene have significantly reduced incidence of atherosclerosis in the carotid artery.

The study examined 120 human subjects. After complete physical exams and blood testing, ultrasonic testing determined their level of thickening of the artery walls in the carotid artery. The carotid artery travels from the heart to the brain. A hardening of that artery can lead to reduced blood flow to the brain, along with stroke and heart attack.

The analysis found that 58 of the subjects had progressive carotid atherosclerosis. Those with carotid atherosclerosis had higher concentrations of triglycerides, LDL-cholesterol, and total cholesterol in their bloodstreams. They also had lower levels of lycopene.

The researchers concluded:

“These data suggest that higher serum levels of lycopene may play a protective role versus cardiovascular diseases, in particular carotid atherosclerosis.”

This research confirms mounting evidence for lycopene as a potent antioxidant. Antioxidants reduce the hardening of the arteries because they neutralize lipid oxidizing radicals that harm the cells of artery walls.

Tomatoes have more cardiovascular benefits when cooked

For vegetables, depending upon the type are often best when eaten raw or steamed. For grains and beans, I typically advise these be cooked thoroughly, as this reduces phytate content and makes their fibers more digestible.

There are a few notable exceptions to the notion that raw fruit will nutritionally outperform cooked fruit. One of these is tomato. (Yes, tomato is considered a fruit, though many people will eat tomatoes with vegetables, which is perfectly fine.)

A 2016 study from the Medicine School at the University of Barcelona, along with researchers from Spain’s Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN) studied the comparative effects of raw and cooked tomatoes on the cardiovascular system.

The researchers tested 40 healthy people over a period of four months. For one day of each month, after 8 hours of fasting (overnight) they each randomly ate one of four ‘feedings’:
1) Raw tomatoes: 7 grams per kilo (about 2.2 lbs.) of body weight
2) Tomato sauce: 3.5 grams per kilo of body weight
3) Tomato sauce cooked with olive oil: 3.5 grams per kilo of body weight
4) sugar dissolved in water: 0.25 grams per kilo of body weight

The amount of sugar was determined to match the calorie level of the other groups.

The researchers then studied the cardiovascular effects of each upon the subjects. Cardiovascular markers were tested before each feeding and six hours after the consumption of the tomato products or the sugar control.

The cardiovascular testing included total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and a number of inflammatory markers: This included interleukin-10 (IL-10) and IL-6. They also tested each subjects’ vascular cell adhesion molecule-1 (VCAM-1) – a test that determines artery health and/or stiffness. They also tested markers for immune health such as lymphocyte function-associated antigen-1 (LFA-1) from T-cells and CD36 from monocytes. They also tested each subject’s blood pressure.

The researchers found that practically every cardiovascular marker above was significantly improved after the subjects ate the raw tomatoes, the cooked tomato sauce and the tomato sauce with olive oil.

This includes significantly lower triglycerides, lower blood pressure (both systolic and diastolic), lower LDL-c, and lower total cholesterol. HDL-cholesterol levels increased.

To give you an idea of significance, the subjects’ triglyceride levels went down by 22.6 mg/dL in the raw tomato group.

Nearly all the artery health markers mentioned above were also improved after eating the tomato products, and immunity markers were also improved. For example, raw tomatoes reduced pro-inflammatory IL-6 levels by 0.30 pg/mL.

However, to the surprise of the researchers, nearly every parameter improved by the tomato products was more improved in the tomato sauce group compared to the raw tomato group. With the examples above, the tomato sauce reduced triglycerides by 28.4 mg/dL and reduced IL-6 by 0.55 pg/mL.

Furthermore, those markers were even higher in the group that ate the tomato sauce blended with olive oil. With the example above, IL-6 levels went down by 1.09 pg/mL in the tomato sauce with olive oil group.

Triglycerides were the exception in the tomato sauce/olive oil group. Triglycerides only went down by 15 mg/dL in this group (yet this is still very significant). The other improved markers were all better in the tomato sauce with olive oil group.

Why were the tomato sauces healthier?

When the researchers analyzed the nutrient components of each of these tomato products, they found that the cooked tomato sauce had greater levels of carotenoids than the raw tomatoes, including lutein (0.38 sauce to 0.20 raw micrograms/gram), alpha-carotene (0.73 to 0.15), beta-carotene (323 to 246), Z-lycopene isomers 1 (12.4 to 5.53) and E-lycopene (39.3 to 36.7)

The cooked tomato sauce also had more polyphenols, more flavonoids, more flavanones, more flavanols, more phenolic acids (5.38 to 2.47) and more total polyphenols (159 to 110).

While the potential for concentrating these nutrients exist during processing, the researchers adjusted for that. They concluded the increased availability was complex:

“Nutrient bioavailability from dietary sources depends on several factors including the breakup of the food matrix, cooking processes and the presence or addition of lipids or other substances. Moreover, nutrients may interact between them or with other dietary components during digestion, changing their bioavailability.”

The researchers also mentioned that they investigated the effects of the olive oil in itself and determined that the addition of the olive oil helped make the tomatoes nutrients more bioavailable than either the raw or the tomato sauce by itself. This is despite the fact that many nutrient levels were a bit higher in the tomato sauce compared to the tomato sauce with olive oil.

Still, the tomato sauce with olive oil had significantly greater levels of nutrients than the raw tomatoes.

This increase in polyphenol bioavailability after blending with oil and cooking was also confirmed by some of the same researchers in a related 2016 study.

How about ketchups and tomato juice?

Other studies have investigated ketchups and tomato juice for their nutrient content. A 2012 study from the University of Barcelona found ketchups contain practically all of the same compounds.

Personally, I would warn that many tomato ketchups often also contain added refined sugar, which would defeat some of the anti-inflammatory effects of the tomatoes.

With regard to tomato juice: In a study from Spain’s University of Murcia, researchers tested 18 women who drank half a liter (500 milliliters) per day of tomato juice for 15 days. The researchers found that drinking plain tomato juice reduced the women’s artery inflammatory factors (artery adhesion molecules) VCAM-1 and ICAM-1 by 47%.

Tomatoes reduce hardening of arteries

Other research has confirmed that lycopene, the carotenoid that makes tomatoes red, lowers the risk of hardening of the arteries. A 2011 study from researchers at the San Camillo de Lellis Hospital Cardiology Unit in Foggia, Italy, used ultrasonic testing and blood tests to determine that those with higher blood levels of lycopene have significantly reduced incidence of atherosclerosis in the carotid artery.

The researchers concluded that, “These data suggest that higher serum levels of lycopene may play a protective role versus cardiovascular diseases, in particular carotid atherosclerosis.”

This study confirms mounting evidence for lycopene as a potent antioxidant. Antioxidants reduce the hardening of the arteries because they neutralize lipid oxidizing radicals that harm the cells of artery walls.

Tomatoes and the Mediterranean Diet

The Mediterranean Diet benefits the heart according to a number of studies. This is because this diet has undergone intense scientific scrutiny over the past four decades, with the result that it is one of the healthiest diets.

Certainly, tomato sauce with olive oil is one of the hallmarks of the Mediterranean Diet. In fact, tomatoes or tomato sauce in one form or another are eaten frequently by those who eat the Med diet.

One thing to consider, however, is dairy and tomatoes. Research has found that eating calcium-rich foods or taking a calcium supplement during or right after eating tomato foods or tomato supplements can significantly block the lycopene uptake in the body. Best to separate your dairy from your tomatoes, so to speak.

So go ahead, have that pizza or pasta with lots of tomato sauce and olive oil. But don’t forget to eat your vegetables and some raw fruits too.

Organic tomatoes taste better and are more nutritious according to other research.

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