Dietary anthocyanins as multifunctional bioactives targeting obesity across experimental and clinical models

Obesity has emerged as a critical global health issue, contributing to cardiometabolic and other chronic diseases. Current management strategies, including diet, lifestyle modification, and pharmacotherapy, often lack sustainable efficacy and carry side effects. The search for safe, natural interventions has drawn attention to plant-based bioactives, particularly anthocyanins, which are abundant in dark-pigmented fruits and exhibit antioxidant and anti-obesogenic effects. This review critically evaluates the anti-obesogenic potential of anthocyanins, drawing on in vitro, preclinical, and clinical studies. Preclinical evidence demonstrates that anthocyanins improve lipid and glycemic profiles and insulin sensitivity, while reducing body weight, adiposity, hepatic steatosis, and systemic inflammation. Clinical trials generally support beneficial effects of anthocyanin-rich foods and supplements on selected cardiometabolic parameters (e.g., lipids, glycemic control, and inflammation) in individuals with overweight or obesity, while effects on body weight and adiposity are modest or inconsistent. Mechanistically, anthocyanins inhibit pancreatic lipase, adipogenesis, and lipogenesis; promote fatty acid β-oxidation through AMP-activated protein kinase (AMPK) driven peroxisome proliferator-activated receptor alpha (PPARα) signaling; enhance thermogenesis via upregulation of uncoupling protein 1 (UCP1) and PR domain-containing 16 (PRDM16); and stimulate mitochondrial biogenesis in adipose tissue. In addition, anthocyanins attenuate oxidative stress and chronic inflammation by reducing reactive oxygen species, pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), and by modulating nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. Furthermore, anthocyanins beneficially modulate the gut microbiota, enriching species such as Akkermansia muciniphila, increasing short-chain fatty acid production, and improving intestinal barrier integrity. Overall, anthocyanins represent a compelling, multi-targeted natural intervention for obesity and its metabolic complications. These natural strategies may complement established pharmacotherapies and, when embedded in plant-forward dietary patterns and sustainable food systems, contribute to a more holistic approach to planetary health.