Dietary Safflower Oil and Cardiometabolic Health: From Molecular Mechanisms to Clinical Implications

Metabolic syndrome, characterised by central obesity, dyslipidemia, hypertension, and insulin resistance, continues to rise globally, presenting substantial health risks. Dietary interventions are increasingly investigated as complementary approaches for managing these metabolic disturbances, with safflower (Carthamus tinctorius L.) emerging as a promising candidate due to its rich content of polyunsaturated fatty acids, particularly linoleic acid, and bioactive flavonoids. This review systematically examines current evidence regarding the biochemical, physiological, and clinical impacts of safflower-derived oils and petal extracts on cardiometabolic health. Experimental studies demonstrate that linoleic acid-rich safflower oil can modulate lipid profiles, reduce circulating triglycerides and LDL cholesterol, and enhance hepatic lipid metabolism, while safflower petal extracts influence glucose homeostasis via the AKT/FoxO1 signalling pathway and exert anti-inflammatory effects through NF-κB and Nrf2 modulation. Additionally, emerging research highlights safflower’s interaction with the gut microbiota, promoting beneficial bacterial populations and regulating metabolite-mediated hepatic glucose production. Despite these benefits, variability in study outcomes is noted, influenced by differences in oil composition, dosage, intervention duration, and metabolic context. Comparisons with other lipid sources indicate that safflower oil provides metabolic advantages over saturated fats, yet omega-3-rich oils may offer superior anti-inflammatory and muscle-preserving effects. Overall, the integration of biochemical, animal, and human clinical data underscores the potential of safflower as a context-specific nutritional intervention for metabolic syndrome. Future research should focus on optimizing formulations, understanding gut-liver interactions, and evaluating long-term clinical efficacy to establish evidence-based dietary strategies that leverage safflower’s unique bioactive profile.