Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation

A unique understanding of traditional medicine of pomegranate, Punica granatum L. and its current research status

ETHNOPHARMACOLOGICAL RELEVANCE

Pomegranate, Punica granatum L., has been used in traditional medicine in China and several regions of the world including Ayurveda, Islamic, and Persian for the treatment of atherosclerosis, diabetes, hypertension, hyperlipidemia, and several types of cancer, as well as for peptic ulcer and oral diseases for hundreds of years. Presently, pomegranate is treated as both a "medicine food homology" herbal medicine and a healthy food supplemental product.

AIM OF THE STUDY

The aim of this work is to develop an overview of pomegranate in the context of the status of its traditional medicine theories, the spread along the Silk Road, ethnopharmacological uses, chemical compositions, pharmacological activities, toxicology, and the involved pathways.

MATERIALS AND METHODS

Information on P. granatum L. was acquired from published materials, including monographs on medicinal plants, ancient and modern recorded classical texts; and pharmacopoeias and electronic databases (PubMed, Science Direct, Web of Science, Google Scholar, CNKI, and Wanfang Data).

RESULTS

Pomegranate has been used in many traditional medical systems throughout history. It is widely cultivated in Central Asia and spread throughout China along the Silk Road. Many phytochemicals, such as tannins, organic acids, flavonoids, alkaloids, and volatile oils have been identified from different parts of pomegranate, these compounds have a wide range of activities, including antioxidant, antimicrobial, and anti-oncogenic properties, as well as conferring resistance to cerebrovascular disease. Furthermore, A summary of the four promising pharmacological pathways is provided.

CONCLUSIONS

The traditional uses, chemical compositions, pharmacological activities, and signaling pathways of pomegranate are summarized comprehensively in the review. It can be treated as a guidance for the future clinical and basic research. The information provided in this review will be very useful for further studies to develop novel therapeutic directions for application of pomegranate.

How combined aerobic training and pomegranate juice intake affect lipid profile? A clinical trial in men with type 2 diabetes

Study aim: This study aimed to investigate the effect of aerobic training (AT) and pomegranate juice intake (PJI) on the lipid profile in men with type 2 diabetes.

Materials and methods: This randomized clinical trial was performed in middle-aged men (40–50 years old) with type 2 diabetes. Participants were randomly assigned into four groups: AT + PJI (n = 9); AT (n = 10); PJI (n = 9), and control (C) (n = 10). The AT program consisted of 60-75% of HRMax, 40-60 min/day, three days/wk for eight weeks. Participants in the PJI group consumed 240 ml of pomegranate juice (sugar or additive-free) daily for eight weeks. Lipid profile was measured at the beginning and end of the study. The data were analyzed through paired t-test and one-way analysis of variance, as well as Tukey’s post hoc test at the signification level of P<0.05.

Results: AT + PJI, PJI, and AT groups demonstrated significant improvements in lipid profile compared to the C group. The results show that the AT + PJI group had significantly lower TC and LDL (p = 0.001 and p = 0.002, respectively), and significantly higher HDL (p = 0.023) compared with the PJI group. There was no significant difference between AT and PJI groups. Also, TG was significantly lower in AT+ PJI compare to the C group.

Conclusions: AT + PJI is more effective than AT or PJI alone in the improvement of lipid profile in patients with type 2 diabetes.

Comparative study of not from concentrate and reconstituted from concentrate of pomegranate juices on nutritional and sensory profile

Pomegranate juice is popular due to its unique health benefits, sensory characteristics and also a good source of bioactive compounds. Comparative study on processing effect of Not from Concentrate (NFC) and Reconstituted from concentrate (RFC) pomegranate juice on the nutritional and sensory characteristics of 'Ganesh' variant was conducted. Results showed that not much differences observed in parameters like pH, acidity, essential elements, protein, total sugars and polyphenol content between NFC and RFC. As per the study NFC had a better antioxidant activity with intracellular ROS inhibition of 11% higher with significant (p < 0.05) than RFC in HepG2 cell lines. Total anthocyanin content was significantly different (p < 0.05) in NFC (428.05 mg/l) compared to 326.74 mg/l in RFC expressed as cyanidin-3-glucoside. Iron uptake was 40 units (µg/mg protein) higher in NFC than RFC (p < 0.05) in HepG2 cells. Sensory flavor profile showed NFC having significant differences with respect to characteristic pomegranate freshness, fruitiness, sweetness and astringency mouthfeel. RFC had higher sweetish and cooked flavor with additional vegetable like notes of beet and carrot. Based on the data better antioxidant activity, iron bioavailability, anthocyanin content and sensory attributes were captured in pomegranate NFC juices over RFC juices.

An Overview of Nanoformulated Nutraceuticals and their Therapeutic Approaches

Background:

Economic development and vast changes in food habits have accelerated the consumption of junk foods, which are the leading causes of several disorders that turn the majority of the people to use various herbal formulations or drugs for preventing various lifestyle diseases. Nutraceuticals are the borderline apparatus between nutrients and drugs that provide supplementation of the particular nutrient with a favorable health effect.

Objective:

Various nutraceutical compounds like vitamins, spices, polyphenols, prebiotics, and probiotics in the form of powders, tablets, and capsules are currently marketed globally. Among them, previous literature have reported that polyphenols are the most promising compounds that have been proven to treat various chronic diseases like cancer, hypertension, diabetes mellitus (DM), osteoporosis, osteoarthritis, dyslipidemia, multiple sclerosis, congenital anomalies, Alzheimer’s disease, etc. It is warranted to discuss the benefits of nanoformulations of nutraceuticals.

Methods:

We have searched PubMed using the keywords nutraceuticals, nanoformulations, therapeutic approaches, bionanotechnology, and therapeutics. The relevant papers and classical papers in this field were selected to write this review.

Results and Discussion:

The different classifications of nutraceuticals were described in this review. The comparison between the different categories of nutraceuticals with their nanoformulated forms was made, explaining the benefits of nanoformulations regarding stability, bioavailability, enhanced anti-oxidant properties, etc. A glimpse of the drawbacks of nanoformulations was also included.

Conclusion:

The current review highlights an overview of various nanoformulated nutraceuticals and their approach towards the treatment of multiple diseases.

Plant Phenolics and Extracts in Animal Models of Preeclampsia and Clinical Trials-Review of Perspectives for Novel Therapies

The current health requirements set the direction in pharmacological research, especially as regards diseases that require improvement of existing therapeutic regimens. Such diseases include preeclampsia, which is a hypertensive disorder of pregnancy during which there occurs progressive increasing activation of the immune system through elevation of pro-inflammatory cytokines and antiangiogenic factors, which is dangerous for the mother and fetus. A promising field of research for new drugs to treat this disease is the study of natural phenolic compounds of plant origin and herbal extracts, which are complex matrices of chemical compounds with broad biological activities. Many plant substances with anti‑inflammatory and anti‑hypertensive properties are known, but studies in animal models of preeclampsia and clinical trials concerning this disease constitute a new and developing research trend of significant medical importance. The aim of our research review was to identify and analyze the results of already available studies on baicalin, curcumin, epigallocatechin gallate, punicalagin, quercetin, resveratrol, salvianolic acid A (danshensu), silibinin, and vitexin, as well as plant extracts from Brassica oleracea L., Euterpe oleracea Mart., Moringa oleifera Lam., Punica granatum L., Silybum marianum (L.) Gaertner, Thymus schimperi Ronniger, Uncaria rhynchophylla (Miq.) Miq. ex Havil., and Vitis vinifera L., which are potential and promising candidates for further research and for potential new therapies.

Therapeutic properties of Punica granatum L (pomegranate) and its applications in lung-based diseases: A detailed review

Respiratory diseases are the prime cause of death and disability worldwide. The majority of lung-based diseases are resistant to treatment. Hence, research on unique drugs/compounds with a more efficient and minimum side effect for treating lung diseases is urgent. Punica granatum L (pomegranate) fruit has been used in the prevention and treatment of various respiratory disorders in recent times. In vivo and in vitro studies have demonstrated that pomegranate fruit, as well as its juice, extract, peel powder, and oil, exert anti-proliferative, anti-oxidant, anti-microbial, anti-inflammatory, anti-cancer, and anti-tumorigenic properties by attenuating various respiratory conditions such as asthma, lung fibrosis, lung cancer, chronic obstructive pulmonary disease (COPD), and alveolar inflammation via modulating various signaling pathways. The current review summarizes the potential properties and medical benefits of pomegranate against different lung-based diseases, also highlighting its possible role in the lung fibrinolytic system. The available data suggest that pomegranate is effective in controlling the disease progressions and could be a potential therapeutic target benefiting human health status. Furthermore, this review also outlines the preclinical and clinical studies highlighting the role of pomegranate in lung diseases further evoking future studies to investigate the effect of intake of this anti-oxidant fruit in larger and well-defined human clinical trials. PRACTICAL APPLICATIONS: This review outlines the putative pharmacologic benefits of P. granatum L (pomegranate) in treating various chronic lung-based diseases such as lung cancer, COPD, ARDS, asthma, lung fibrosis, and cystic fibrosis. This review also highlights the possible inhibitory role of P. granatum L (pomegranate) in the lung fibrinolytic system triggering the fibrinolytic markers. This review summarizes the preclinical and clinical studies using in vitro, in vivo, and human models highlighting the potential role of P. granatum L (pomegranate) in lung diseases. This review evokes future research to investigate the effect of intake of pomegranate fruit in well-defined human clinical trials.

The role of high-density lipoprotein cholesterol, apolipoprotein A and paraoxonase-1 in the pathophysiology of neuroprogressive disorders

Lowered high-density lipoprotein (HDL) cholesterol has been reported in major depressive disorder, bipolar disorder, first episode of psychosis, and schizophrenia. HDL, its major apolipoprotein component, ApoA1, and the antioxidant enzyme paraoxonase (PON)1 (which is normally bound to ApoA1) all have anti-atherogenic, antioxidant, anti-inflammatory, and immunomodulatory roles, which are discussed in this paper. The paper details the pathways mediating the anti-inflammatory effects of HDL, ApoA1 and PON1 and describes the mechanisms leading to compromised HDL and PON1 levels and function in an environment of chronic inflammation. The molecular mechanisms by which changes in HDL, ApoA1 and PON1 might contribute to the pathophysiology of the neuroprogressive disorders are explained. Moreover, the anti-inflammatory actions of ApoM-mediated sphingosine 1-phosphate (S1P) signalling are reviewed as well as the deleterious effects of chronic inflammation and oxidative stress on ApoM/S1P signalling. Finally, therapeutic interventions specifically aimed at improving the levels and function of HDL and PON1 while reducing levels of inflammation and oxidative stress are considered. These include the so-called Mediterranean diet, extra virgin olive oil, polyphenols, flavonoids, isoflavones, pomegranate juice, melatonin and the Mediterranean diet combined with the ketogenic diet.

Precision Nutrition to Activate Thermogenesis as a Complementary Approach to Target Obesity and Associated-Metabolic-Disorders

Simple Summary

Regarding the pandemic of obesity and chronic diseases associated to metabolic alterations that occur nowadays worldwide, here, we review the most recent studies related to bioactive compounds and diet derived ingredients with potential effects to augment the systemic energy expenditure. We specifically focus in two processes: the activation of thermogenesis in adipose tissue and the enhancement of the mitochondrial oxidative phosphorylation capacity in muscles. This may provide relevant information to develop diets and supplements to conduct nutritional intervention studies with the objective to ameliorate the metabolic and chronic inflammation in the course of obesity and related disorders.

Abstract

Obesity is associated to increased incidence and poorer prognosis in multiple cancers, contributing to up to 20% of cancer related deaths. These associations are mainly driven by metabolic and inflammatory changes in the adipose tissue during obesity, which disrupt the physiologic metabolic homeostasis. The association between obesity and hypercholesterolemia, hypertension, cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) is well known. Importantly, the retrospective analysis of more than 1000 epidemiological studies have also shown the positive correlation between the excess of fatness with the risk of cancer. In addition, more important than weight, it is the dysfunctional adipose tissue the main driver of insulin resistance, metabolic syndrome and all cause of mortality and cancer deaths, which also explains why normal weight individuals may behave as “metabolically unhealthy obese” individuals. Adipocytes also have direct effects on tumor cells through paracrine signaling. Downregulation of adiponectin and upregulation of leptin in serum correlate with markers of chronic inflammation, and crown like structures (CLS) associated to the adipose tissue disfunction. Nevertheless, obesity is a preventable risk factor in cancer. Lifestyle interventions might contribute to reduce the adverse effects of obesity. Thus, Mediterranean diet interventional studies have been shown to reduce to circulation inflammatory factors, insulin sensitivity and cardiovascular function, with durable responses of up to 2 years in obese patients. Mediterranean diet supplemented with extra-virgin olive oil reduced the incidence of breast cancer compared with a control diet. Physical activity is another important lifestyle factor which may also contribute to reduced systemic biomarkers of metabolic syndrome associated to obesity. In this scenario, precision nutrition may provide complementary approaches to target the metabolic inflammation associated to “unhealthy obesity”. Herein, we first describe the different types of adipose tissue -thermogenic active brown adipose tissue (BAT) versus the energy storing white adipose tissue (WAT). We then move on precision nutrition based strategies, by mean of natural extracts derived from plants and/or diet derived ingredients, which may be useful to normalize the metabolic inflammation associated to “unhealthy obesity”. More specifically, we focus on two axis: (1) the activation of thermogenesis in BAT and browning of WAT; (2) and the potential of augmenting the oxidative capacity of muscles to dissipate energy. These strategies may be particularly relevant as complementary approaches to alleviate obesity associated effects on chronic inflammation, immunosuppression, angiogenesis and chemotherapy resistance in cancer. Finally, we summarize main studies where plant derived extracts, mainly, polyphenols and flavonoids, have been applied to increase the energy expenditure.

Development and screening of byproduct for its secondary metabolites, antioxidant and anti-diabetic potential from anthracnose-infected fruits of pomegranate: a sustainable approach

The main focus of the present study was to analyze the antioxidant and anti-diabetic potential of fermentative byproduct, developed from anthracnose-infected pomegranate fruits. The analysis of fermented juice showed a reduction in total phenolic content, total flavanoid content, anthocyanins, and antioxidant potential over the time in 6 months as compared to fresh juice, while total protein and alcohol percent (11%) were increased. Measurements of antioxidant activity by DPPH, ABTS, superoxide radical scavenging activity, and reducing power assays were highly correlated to total phenolic content, with corresponding R ² values as r _DPPH = 0.88, r _ABTS = 0.90, r _SRS = 0.67, r _RPA = 0.80. High-performance liquid chromatography clearly revealed that the increment of antioxidant activity is associated with the release of gallic acid, vanillin, and ferulic acid. LC-MS analysis identified 1263 metabolites in fresh juice, 1580 metabolites after 1 month of fermentation, and 1063 metabolites after 6 months of fermentation. Most of the detected metabolites are linked with antioxidant, anti-diabetic, phenolics, flavanoids, cardiac glycosides, anticancer, and anti-vomiting activity. Mainly, naphthofluorescein, CAY10599, CAY10506, aminofluoropropionic acid, and 8-azaadenosine anti-diabetic compounds were found in fresh juice and fermented juice. Administration of fresh juice and fermented juice for 1 month helped in the reduction of blood plasma glucose level from 112.6 to 94.73 mg/dL before food and 142.43 to 133.20 mg/dL after food as compared to prescribed medicine. The sensory attributes of fermented juice were well appreciated for taste, after taste, and flavor. Further research is necessary to improve the quality and stability of metabolites during storage.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13205-020-02629-z.

Effects of flavonoid-rich fruits on hypertension in adults: a systematic review

OBJECTIVE

The objective of this systematic review was to synthesize the best available research evidence on the effectiveness of flavonoid-rich fruits in the treatment of hypertension.

INTRODUCTION

Hypertension is a serious public health concern as it contributes to a significant burden of disease, leading to millions of deaths globally. Complementary therapies including flavonoids have generated interest in assisting the treatment of hypertension. Flavonoids are a type of polyphenol abundant in fruits and a growing body of evidence suggests antihypertensive effects of the flavonoids due to their antioxidant properties. To date, no systematic review has been performed to collate the evidence on the effects of flavonoid-rich fruits on hypertension in adults.

INCLUSION CRITERIA

This systematic review included randomized controlled trials (RCTs) that compared the administration of any type of flavonoid-rich fruit or equivalent supplement with a placebo or other intervention in adults with hypertension. Trials that measured blood pressure using objective outcome measures such as a manual mercury sphygmomanometer were included. Studies that did not specify the flavonoid component of the fruit or fruit supplement were excluded from the review. Secondary outcomes, including change in weight, blood glucose level, triglycerides and total blood cholesterol levels, were also assessed.

METHODS

A three-step search was undertaken, including a comprehensive search of the MEDLINE, Embase, Cochrane Trials (CENTRAL) and CINAHL databases, in September 2018. We also searched Dissertation Abstracts International, ProQuest Dissertations and Theses, MedNar and ClinicalTrials.gov to identify unpublished studies. The title and abstracts of the studies were reviewed by two independent reviewers against the inclusion/exclusion criteria. The methodological quality of the potential studies for inclusion were assessed using the critical appraisal checklist for randomized controlled trials as recommended by JBI. Data were pooled in a statistical meta-analysis model. Subgroup-analysis according to type of intervention and length of intervention period was performed. Where statistical pooling was not possible, the findings have been presented in a narrative form.

RESULTS

Fifteen randomized controlled trials involving 572 participants were included in the review. The subclasses of flavonoids assessed included: anthocyanins, naringin, narirutin and flavan-3-ols. The overall methodological quality of the trials was high. Six trials investigated the effect of the flavonoid intervention on blood pressure within four weeks. Meta-analysis of four of the trials demonstrated no effect of flavonoids on systolic or diastolic blood pressure when compared to placebo (systolic mean difference = -1.02, 95% confidence interval [CI] -3.12, 1.07; p = 0.34, I = 0%; diastolic mean difference = -0.90, 95% CI -2.10, 0.31; p = 0.15, I = 0%). Similarly, pooled results from two crossover RCTs with two-timed dosed interventions in a 24-hour period demonstrated no effect on a reduction in diastolic blood pressure (p = 0.38) but did reveal evidence of a reduction in systolic blood pressure (p = 0). Six trials assessed blood pressure following the flavonoid intervention at more than four weeks follow-up. Meta-analysis of five of the trials demonstrated evidence of no effect on either systolic blood pressure (mean difference = -0.95, 95%CI -3.58, 1.68; p = 0.478, I = 0%) or diastolic blood pressure (mean difference = 0.86, 95%CI -1.11, 2.82; p = 0.393, I = 0%).

CONCLUSIONS

The findings of this systematic review should be interpreted with caution, given that the results are obtained from single-center trials with small sample sizes. Flavonoids have no effect on systolic and diastolic blood pressure. Further robust RCTs using sample sizes based on power calculations are needed to provide evidence for the use of flavonoid-rich fruits for the management of hypertension.

Pomegranate: Nutraceutical with Promising Benefits on Human Health

Pomegranate is an old plant made up by flowers, roots, fruits and leaves, native to Central Asia and principally cultivated in the Mediterranean and California (although now widespread almost all over the globe). The current use of this precious plant regards not only the exteriority of the fruit (employed also for ornamental purpose) but especially the nutritional and, still potential, health benefits that come out from the various parts composing this one (carpellary membranes, arils, seeds and bark). Indeed, the phytochemical composition of the fruit abounds in compounds (flavonoids, ellagitannins, proanthocyanidins, mineral salts, vitamins, lipids, organic acids) presenting a significant biological and nutraceutical value. For these reasons, pomegranate interest is increased over the years as the object of study for many research groups, particularly in the pharmaceutical sector. Specifically, in-depth studies of its biological and functional properties and the research of new formulations could be applied to a wide spectrum of diseases including neoplastic, cardiovascular, viral, inflammatory, metabolic, microbial, intestinal, reproductive and skin diseases. In this review, considering the increasing scientific and commercial interest of nutraceuticals, we reported an update of the investigations concerning the health-promoting properties of pomegranate and its bioactive compounds against principal human pathologies.

Developmental and social deficits and enhanced sensitivity to prenatal chlorpyrifos in PON1-/- mouse pups and adults

The levels and activity of the enzyme paraoxonase 1 affect the vulnerability to the teratogenic effects of organophosphate pesticides. Mutant mice lacking the gene for paraoxonase1 (PON1^-/-) are more susceptible to the toxic effects of chlorpyrifos, and were hypothesized to be more vulnerable to social behavior deficits induced by exposure to chlorpyrifos during gestation. Three experiments were performed comparing PON1^-/- mice to PON1^+/+ mice born to dams treated with 0.5 mg/kg chlorpyrifos or cornoil vehicle on gestational days 12–15. Chlofpyrifos-exposed male PON1^-/- mouse pups had delayed development of reflexes in in the first experiment. In the second experiment, adult male and female PON1^-/- mice and the female PON1^+/+ mice all displayed lower social preference than the male vehicle-treated PON1^+/+ mice. The PON1^-/- mice and the female PON1^+/+ mice displayed lower social preference compared to the PON1^+/+ male mice. Male adult mice that had been exposed in utero to chlorpyrifos showed less conditioned social preference regardless of genotype. In the third study, the delayed reflex development was replicated in male and female PON1^-/- mice, but chlorpyrifos did not augment this effect. Nest Odor Preference, a test of early social attachment to dam and siblings, was lower in PON1^-/- mouse pups compared to PON1^+/+ pups. This study shows for the first time that PON1^-/- mice have a behavioral phenotype that indicates impaired reflex development and social behavior. Chlorpyrifos exposure during gestation tended to augment some of these effects.

Punica protopunica Balf., the Forgotten Sister of the Common Pomegranate (Punica granatum L.): Features and Medicinal Properties-A Review

Punica protopunica Balf. is one of only two species housed by the Punica genera. Punica protopunica. Balf., known as Socotran pomegranate, is an endemic, isolated species found only in Socotra archipelago in the northwestern Indian Ocean, and is considered to be the ancestor of pomegranate. This review stems from the fact that in many Punica granatum L. articles, Punica protopunica Balf. is mentioned, but just in an informative way, without mentioning their taxonomic and genetic relationship and their medicinal properties. It is there where the need arises to know more about this forgotten species: “the other pomegranate tree.” A large part of the human population does not know of its existence, since only its “sister” has spread throughout the world. The present review deals with the taxonomy and origin of Punica protopunica Balf., the morphology of the tree, distribution, cultivation, vulnerability, and as well as its relationship with Punica granatum L. It also discusses its uses in traditional medicine, its antioxidant capacity, and the medicinal properties of this forgotten species.

Effect of Sunlight Exposure on Anthocyanin and Non-Anthocyanin Phenolic Levels in Pomegranate Juices by High Resolution Mass Spectrometry Approach

Quali-quantitative analyses of anthocyanins and non-anthocyanin phenolic compounds performed with the use of liquid chromatography coupled with high resolution mass spectrometry, were evaluated in juice of pomegranate fruits ('Dente di Cavallo'), in relation to different light exposures (North, South, West and East). A total of 16 compounds were identified, including phenolic acids, flavonoids, hydrolysable tannins, and anthocyanins, known for their health-promoting effects. Striking differences were observed about the total phenolic content, which was high in juices from fruits with east- and north-facing position, while it was lower in juices facing south. The greatest contents of total flavonoids and anthocyanins were recorded in fruit juices with southern exposure; however, there are no great differences in the content in phenolic acids. Tannins were mainly synthesized in fruit juices with West exposure. The results showed that the position within the tree had no significant effects on color juice, however, it significantly (p < 0.05) affected data on fruit weight, soluble sugars and juice yield. Remarkable synergies existed among polyphenols and phytochemicals in pomegranate juice, but collecting fruits with different solar exposure could enhance different health benefits, i.e., the juices with higher polyphenols content could have more anticancer effect or those with higher tannins content could have more antimicrobial effect.

Effects of natural polyphenol-rich pomegranate juice supplementation on plasma ion and lipid profiles following resistance exercise: a placebo-controlled trial

Background

Pomegranate juice (POMj) contains abundant soluble polyphenolic antioxidant compounds and is recommended for its cardioprotective/atheroprotective properties. However, very few studies have investigated the efficacy of POMj supplementation to alter physiological responses during intensive physical exercise. This placebo-controlled study aimed to examine whether supplementation with natural polyphenol-rich-POMj could influence the ionic or lipid responses to an intensive resistance training session in elite athletes.

Methods

Nine elite weightlifters (21 ± 1 years) performed two Olympic-weightlifting sessions after ingesting placebo and POMj supplements. Venous blood samples were collected at rest and 3 min after each session for assessment of plasma sodium ([Na⁺]), potassium ([K⁺]), chloride ([Cl^-]), calcium ([Ca²⁺]), triglyceride ([TG]) and high-density lipoprotein ([HDL-C]), low-density lipoprotein ([HDL-C]) and total ([TC]) cholesterol concentrations.

Results

Plasma [K⁺] and [TG] were lowered post-exercise compared to resting values in the PLA condition (p = 0.03 for K⁺ and p = 0.02 for TG) with no pre-to-post exercise differences in the other plasma ion and lipid markers (p > 0.05). Compared to rest, plasma [Na⁺] and [Cl^-] were increased (p = 0.04, %change = 4.10% for Na⁺ and p = 0.02, %change = 4.44% for Cl^-), but there were no differences in the other plasma ion or lipid markers post-exercise after POMj supplementation (p > 0.05). Post-exercise plasma [Na⁺], [Cl^-], and [HDL-C] were greater following POMj supplementation compared to PLA (p = 0.01 for Cl- and HDL-C, p = 0.02 for Na+, and p = 0.04 for TC), with no between-supplement post-exercise differences in the other ion and lipid markers (p > 0.05).

Conclusion

In conclusion, supplementation with POMj has the potential to attenuate the acute imbalance of plasma [K⁺] and to improve blood lipid responses (i.e., HDL-C) following resistance exercises in elite weightlifters. However, further large research in both athletic and non-athletic populations is needed to corroborate these preliminary observations and to elucidate the potential underlying mechanisms and translational potential of our novel observations.

Trial registration

Name of the registry:ClinicalTrials.gov PRSThe registration number:NCT02697903.Date of Registry: 03/03/2016 'Retrospectively registered'.The registration title: Pomegranate Improve Biological Recovery Kinetics in Elite Weightlifter.

Graphical abstract

Polyphenols Regulate Endothelial Functions and Reduce the Risk of Cardiovascular Disease

BACKGROUND

Previous studies have shown that intake of polyphenols through the consumption of vegetables and fruits reduces the risk of Cardiovascular Disease (CVD) by potentially influencing endothelial cell function.

OBJECTIVE

In this review, the effects and molecular mechanisms of plant polyphenols, particularly resveratrol, epigallocatechin gallate (EGCG), and quercetin, on endothelial functions, and their putative protective effects against CVD are described.

METHODS

Epidemiologic studies examined the effect of the CVD risk of vegetables and the fruit. Furthermore, studies within vitro models investigated the underlying molecular mechanisms of the action of the flavonoid class of polyphenols. These findings help elucidate the effect of polyphenols on endothelial function and CVD risk reduction.

RESULTS

Epidemiologic and in vitro studies have demonstrated that the consumption of vegetables and fruits decreases the incidence of CVDs. Furthermore, it has also been indicated that dietary polyphenols are inversely related to the risk of CVD. Resveratrol, EGCG, and quercetin prevent oxidative stress by regulating the expression of oxidase and the antioxidant enzyme genes, contributing to the prevention of stroke, hypertension, heart failure, and ischemic heart disease.

CONCLUSION

High intake of dietary polyphenols may help prevent CVD. Polyphenols inhibit endothelial dysfunction and induce vascular endothelium-dependent vascular relaxation viz. redox regulation and nitric oxide production. The polyphenol-induced healthy endothelial cell function may be related to CVD prevention.

Effects of natural polyphenol-rich pomegranate juice on the acute and delayed response of Homocysteine and steroidal hormones following weightlifting exercises: a double-blind, placebo-controlled trial

BACKGROUND

Maximal strength-speed exercise is a powerful stimulus to acutely increase concentrations of circulating steroid hormones and homocysteine [Hcy]. There is some evidence that antioxidant beverages rich in polyphenols can attenuate [Hcy] levels and modulate endocrine responses in favor of an anabolic environment. Polyphenols-rich pomegranate (POM) have been reported to possess one of the highest antioxidant capacities compared to other purported nutraceuticals and other food stuffs. Studies focused on proving the beneficial effect of POM consumption during maximal strength exercises have only measured physical performance, muscle damage, oxidative stress and inflammatory responses, while POM effects on [Hcy] and hormonal adaptations are lacking. The aim of the present study was to investigate the effect of consuming natural polyphenol-rich pomegranate juice (POMj) on the acute and delayed [Hcy] and steroidal hormonal responses to a weightlifting exercises session.

METHODS

Nine elite weightlifters (21.0 ± 1 years) performed two Olympic-weightlifting sessions after ingesting either the placebo (PLA) or POMj supplements. Venous blood samples were collected at rest and 3 min and 48 h after each session.

RESULTS

Compared to baseline values, circulating cortisol [C] decreased (p < 0.01) and testosterone/cortisol [T/C] ratio increased immediately following the training session in both PLA and POMj conditions (p = 0.003 for PLA and p = 0.02 for POM). During the 48 h recovery period, all tested parameters were shown to recover to baseline values in both conditions with significant increases in [C] and decreases in [T/C] (p < 0.01 for PLA and p < 0.05 for POMj) from 3 min to 48 h post-exercises. Compared to PLA, a lower level of plasma testosterone [T] was registered 3 min post exercise using POMj supplementation (p = 0.012) and a significant decrease (p = 0.04, %change = - 14%) in plasma [Hcy] was registered during the 48 h recovery period only using POMj. A moderate correlation was observed between [Hcy] and [T] responses (p = 0.002, r = - 0.50).

CONCLUSION

In conclusion, supplementation with POMj has the potential to attenuate the acute plasma [T] response, but did not effect 48 h recovery kinetics of [Hcy] following weightlifting exercise. Further studies investigating androgen levels in both plasma and muscular tissue are needed to resolve the functional consequences of the observed acute POMj effect on plasma [T].

TRIAL REGISTRATION

Clinical Trials.gov, ID: NCT02697903. Registered 03 March 2016.

Composition and Potential Health Benefits of Pomegranate: A Review

BACKGROUND

Pomegranate (Punica granatum L.) fruits are widely consumed and used as preventive and therapeutic agents since ancient times. Pomegranate is a rich source of a variety of phytochemicals, which are responsible for its strong antioxidative and anti-inflammatory potential.

OBJECTIVE

The aim of this review is to provide an up-to-date overview of the current knowledge of chemical structure and potential health benefits of pomegranate.

METHODS

A comprehensive search of available literature.

RESULTS

The review of the literature confirms that juice and extracts obtained from different parts of this plant, including fruit peel, seeds, and leaves exert health benefits in both in vitro and in vivo studies. The antidiabetic, antihypertensive, antimicrobial and anti-tumour effects of pomegranate fruit are of particular scientific and clinical interest.

CONCLUSION

Further investigations are required to clarify the mechanism of action of the bioactive ingredients and to reveal full potential of pomegranate as both preventive and therapeutic agent.

The effects of pomegranate supplementation on biomarkers of inflammation and endothelial dysfunction: A meta-analysis and systematic review

OBJECTS

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. CVD is associated with increased levels of reactive oxygen species which are pro-inflammatory and can damage the endothelium. The pomegranate fruit is a rich source of phytochemicals with a high antioxidant and anti-inflammatory activity, possessing thus health benefits. This systematic review and meta-analysis aims to evaluate the effect of pomegranate juice on the biomarkers of inflammation and vascular dysfunction.

METHODS

Studies were identified using the PubMed/Medline and SCOPUS databases. Screening of relevant articles and references was carried out from inception until May 2019. This systematic review and meta-analysis was performed using the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

Overall, 16 randomized controlled trials (RCTs) involving 572 subjects were included in this study. Combining effect sizes from 16 studies, we recorded that pomegranate supplementation significantly reduced hs-CRP, IL-6 and TNF-α (Weighted Mean Diff ;erences (WMD): -6.57 mg/L, 95 % CI: -10.04 to -3.10, P = 0.000; WMD: -1.68 pg/mL, 95 % CI: -3.52, 0.157, P = 0.000; WMD: -2.37 pg/mL, 95 % CI: -3.67, -1.07, P = 0.00, respectively) levels, when compared to placebo. No significant reduction was found in CRP (WMD: 2.19 mg/dL, 95 % CI: -3.28, 7.67, P = 0.61), E-selectin (WMD: 8.42 ng/mL, 95 % CI: -22.9, 39.8, P = 0.599), ICAM (WMD= -17.38 ng/mL, 95 % CI: -53.43, 18.66, P = 0.107), VCAM (WMD: -69.32 ng/mL, 95 % CI: -229.26, 90.61, P = 0.396) or MDA (WMD: 0.031 μmol/L, 95 % CI: -1.56, 0.218, P = 0.746) comparing pomegranate supplementation to placebo.

CONCLUSION

We found a significant effect of pomegranate supplementation on hs-CRP, IL-6 and TNF-α in adults. However, the effects of pomegranate supplementation on CRP, E-selectin, ICAM, VCAM or MDA were not significant in this meta-analysis.

Fruits

Fruits come in a wide variety of colors, shapes, and flavors. This chapter will cover selected fruits that are known to be healthy and highly nutritious. These fruits were chosen due to their common usage and availability. Since it is not possible to cover all health benefits or essential nutrients and important phytochemicals of the fruit composition, this chapter will focus on the key valuable constituents and their potential health effects.

A Moderate-Fat Diet with One Avocado per Day Increases Plasma Antioxidants and Decreases the Oxidation of Small, Dense LDL in Adults with Overweight and Obesity: A Randomized Controlled Trial

BACKGROUND

Avocados are a nutrient-dense source of MUFAs and are rich in antioxidants. Avocados have an additional LDL cholesterol (LDL-C) lowering effect beyond that observed when their MUFAs are substituted for SFAs, especially on small, dense LDL (sdLDL) particles, which are susceptible to in vivo oxidation and associated with increased risk of cardiovascular disease (CVD).

OBJECTIVES

We investigated whether a healthy diet with 1 avocado daily decreased the following secondary outcomes: circulating oxidized LDL (oxLDL) and related oxidative stress markers.

METHODS

A randomized, crossover, controlled feeding trial was conducted with 45 men and women, aged 21-70 y, with overweight or obesity and elevated LDL-C (25th-90th percentile). Three cholesterol-lowering diets were provided (5 wk each) in random sequences: a lower-fat (LF) diet (24% calories from fat-7% SFAs, 11% MUFAs, 6% PUFAs) and 2 moderate-fat (MF) diets (34% calories from fat-6% SFAs, 17% MUFAs, 9% PUFAs): the avocado (AV) diet included 1 Hass avocado (∼136 g) per day, and the MF diet used high oleic acid oils to match the fatty acid profile of 1 avocado. A general linear mixed model was used to analyze the treatment effects.

RESULTS

Compared with baseline, the AV diet significantly decreased circulating oxLDL (-7.0 U/L, -8.8%, P = 0.0004) and increased plasma lutein concentration (19.6 nmol/L, 68.7%, P < 0.0001), and both changes differed significantly from that after the MF and LF diets (P ≤ 0.05). The change in oxLDL caused by the AV diet was significantly correlated with the changes in the number of sdLDL particles (r = 0.32, P = 0.0002) but not large, buoyant LDL particles.

CONCLUSIONS

One avocado a day in a heart-healthy diet decreased oxLDL in adults with overweight and obesity, and the effect was associated with the reduction in sdLDL. This trial was registered at http://www.clinicaltrials.gov as NCT01235832.

Small RNA and mRNA Sequencing Reveal the Roles of microRNAs Involved in Pomegranate Female Sterility

Female sterility is a key factor restricting plant reproduction. Our previous studies have revealed that pomegranate female sterility mainly arose from the abnormality of ovule development. MicroRNAs (miRNAs) play important roles in ovule development. However, little is known about the roles of miRNAs in female sterility. In this study, a combined high-throughput sequencing approach was used to investigate the miRNAs and their targeted transcripts involved in female development. A total of 103 conserved and 58 novel miRNAs were identified. Comparative profiling indicated that the expression of 43 known miRNAs and 14 novel miRNAs were differentially expressed between functional male flowers (FMFs) and bisexual flowers (BFs), 30 known miRNAs and nine novel miRNAs showed significant differences among different stages of BFs, and 20 known miRNAs and 18 novel miRNAs exhibited remarkable expression differences among different stages of FMFs. Gene ontology (GO) analyses of 144 predicted targets of differentially expressed miRNAs indicated that the “reproduction process” and “floral whorl development” processes were significantly enriched. The miRNA–mRNA interaction analyses revealed six pairs of candidate miRNAs and their targets associated with female sterility. Interestingly, pg-miR166a-3p was accumulated, whereas its predicted targets (Gglean012177.1 and Gglean013966.1) were repressed in functional male flowers (FMFs), and the interaction between pg-miR166a-3p and its targets (Gglean012177.1 and Gglean013966.1) were confirmed by transient assay. A. thaliana transformed with 35S-pre-pg-miR166a-3p verified the role of pg-miR166a-3p in ovule development, which indicated pg-miR166a-3p’s potential role in pomegranate female sterility. The results provide new insights into molecular mechanisms underlying the female sterility at the miRNA level.

Pomegranate Juice does not Affect the Bioavailability of Cyclosporine in Healthy Thai Volunteers

Background

It is still controversial whether pomegranate causes drug interactions. Pomegranate juice has been shown to inhibit CYP3A in-vitro and animal studies. The co-administration of pomegranate juice with cyclosporine, a narrow therapeutic drug that is the substrate of CYP3A, might lead to drug toxicity. The objective of this study is to investigate the effect of pomegranate juice on the pharmacokinetics of cyclosporine in healthy Thai volunteers.

Methods

The study design was an open-label, randomized, single dose, crossover study with a 2-week washout period. Each fasting subject received 2 microemulsion tablets of 100 mg of cyclosporine with 500 ml of pomegranate juice (test) or 500 ml of water (control). Serial blood samples were collected up to 24 h after dosing, and blood samples were analyzed for cyclosporine concentrations by using chemiluminescent microparticle immunoassay. Fourteen healthy volunteers completed the study.

Results

The 90% confidence intervals for the test/control ratio using logarithmically transformed data of area under the concentration-time curve (AUC) from time zero until the last measured concentration (AUC0-t), AUC from time zero to infinity (AUC0-∞), and maximum concentration (Cmax) were 91.6-105.6, 92.0-105.2 and 82.3-102.5, respectively. The results were within the accepted bioequivalence range for narrow therapeutic index drugs (90-111% for AUC and 80-125% for Cmax). There were no differences in adverse event between the groups.

Conclusion

Single dose administration of pomegranate juice with cyclosporine did not significantly affect the oral bioavailability of cyclosporine. However, further work is needed to thoroughly evaluate the effect of pomegranate on narrow therapeutic drugs.

Randomized placebo-controlled study of the memory effects of pomegranate juice in middle-aged and older adults

BACKGROUND

Antioxidant nutrients such as the polyphenols in pomegranate juice may prevent neuronal damage from the free radicals produced during normal metabolism. Previous research in animals and a short-term clinical trial in middle-aged and older adults support the potential memory benefits of pomegranate juice; however, the long-term effects of pomegranate juice consumption on cognition have not been studied.

OBJECTIVE

In this study, we investigated the long-term effect of pomegranate juice on memory in nondemented middle-aged and older adults.

METHODS

We performed a 12-month, randomized, double-blind, placebo-controlled trial of pomegranate juice in middle-aged and older adults. Two hundred and sixty-one subjects (aged 50-75 y) were randomly assigned to consume pomegranate juice [8 oz (236.5 mL) per day] or a placebo drink (8 oz, matched constituents of pomegranate juice except for pomegranate polyphenols). Memory measures [Brief Visuospatial Memory Test-Revised (BVMT-R) and Buschke Selective Reminding Test (SRT)] were assessed at 6 and 12 mo and analyzed using a mixed-effects general linear model.

RESULTS

Twenty-eight subjects in the pomegranate juice group and 33 subjects in the placebo group dropped out before completing the study. Baseline variables in the 98 pomegranate juice and 102 placebo group subjects who completed the study did not differ significantly. Group by time interaction was statistically significant for BVMT-R Learning (F[2, 257]= 5.90, P = 0.003; between-group effect size [ES] = 0.45): the change within the pomegranate group was not significant (ES = 0.15), whereas the placebo group showed a significant decline (ES = -0.35). Changes in the other BVMT-R scores as well as the SRT measures were not significantly different between groups.

CONCLUSIONS

Daily consumption of pomegranate juice may stabilize the ability to learn visual information over a 12-mo period. This trial was registered at clinicaltrials.gov as NCT02093130.

Impact of Red Wine Consumption on Cardiovascular Health

BACKGROUND

The devastating effects of heavy alcohol drinking have been long time recognized. In the last decades, potential benefits of modest red wine drinking were suggested. In European countries in which red wide intake is not negligible (such as France), the association between cholesterol and cardiovascular (CV) risk was less evident, suggesting the action of some protective molecules in red wine or other foods and drinks.

METHODS

This narrative review is based on the material searched for and obtained via PubMed up to May 2016. The search terms we used were: "red wine, cardiovascular, alcohol" in combination with "polyphenols, heart failure, infarction".

RESULTS

Epidemiological and mechanistic evidence of a J-shaped relationship between red wine intake and CV risk further supported the "French paradox". Specific components of red wine both in vitro and in animal models were discovered. Polyphenols and especially resveratrol largely contribute to CV prevention mainly through antioxidant properties. They exert beneficial effects on endothelial dysfunction and hypertension, dyslipidemia, metabolic diseases, thus reducing the risk of adverse CV events such as myocardial infarction ischemic stroke and heart failure. Of interest, recent studies pointed out the role of ethanol itself as a potential cardioprotective agent, but a clear epidemiological evidence is still missing. The aim of this narrative review is to update current knowledge on the intracellular mechanism underlying the cardioprotective effects of polyphenols and ethanol. Furthermore, we summarized the results of epidemiological studies, emphasizing their methodological criticisms and the need for randomized clinical trials able to clarify the potential role of red wine consumption in reducing CV risk.

CONCLUSION

Caution in avowing underestimation of the global burden of alcohol-related diseases was particularly used.

The Effects of Anthocyanins and Their Microbial Metabolites on the Expression and Enzyme Activities of Paraoxonase 1, an Important Marker of HDL Function

High circulating HDL concentrations and measures of various HDL functions are inversely associated with cardiovascular disease (CVD) risk. Paraoxonase 1 (PON1) contributes to many of the athero-protective functions of HDL, such as promoting the reverse cholesterol transport process and reducing the levels of oxidized LDL. PON1 activities are influenced by several factors, the most important being diet and genetic polymorphisms. Reported data from randomized controlled trials have shown that anthocyanin consumption increased PON1 activity. However, the underlying molecular mechanisms by which anthocyanins increase PON1 activity are not understood. Therefore, the aim of this research was to investigate the ability of anthocyanins and their metabolites to increase PON1 gene expression and/or enzyme activities as potential mechanisms. The effect of the two predominant dietary anthocyanins and 18 of their recently identified microbial metabolites including their phase-II conjugates on PON1 gene expression was studied using a PON1-Huh7 stably-transfected cell line and reporter gene assay. The effects of these compounds on PON1 arylesterase and lactonase activities were investigated using two isoforms of the PON1 enzyme that are the phenotypes of the 192Q/R polymorphism. None of the compounds caused even modest changes in PON1 promoter activity (p ≥ 0.05). Further, none of the compounds at physiological concentrations caused any significant changes in the arylesterase or lactonase activity of either of the iso-enzymes. Cyanidin reduced the lactonase activity of the PON1-R192R enzyme at high concentrations (−22%, p < 0.001), but not at physiologically achievable concentrations. In conclusion, none of the data reported here support the notion that anthocyanins or their metabolites affect PON1 transactivation or enzyme activities.

High Dose Pomegranate Extract Suppresses Neutrophil Myeloperoxidase and Induces Oxidative Stress in a Rat Model of Sepsis

Abstract. Introduction: The effect of using high dose pomegranate extract on sepsis and its safety is not clarified. Considering the fact that proper immune and inflammatory responses are needed to cope with infection, the aim of current study was to assess the effect of high dose pomegranate extract consumption on oxidative and inflammatory responses after disease induction in rat model of sepsis. Methods: Sepsis was induced by Cecal Ligation and Perforation (CLP) surgery. Adult male Wistar rats were divided into three groups of eight animals: Sham; CLP and POMx [consumed POMx (250 mg of pomegranate fruit extract/kg/day) for four weeks before CLP]. Results: Peritoneal neutrophil myeloperoxidase activity was significantly lower in POMx compared with Sham and CLP groups ( p < 0.01 and p < 0.05, respectively). Although antioxidant enzymes were higher in POMx group after sepsis induction, lower serum total antioxidant status (TAS) (p < 0.01 compared with both CLP and Sham groups) and higher liver thiobarbituric acid reactive species (TBARS) levels were observed in this group ( p < 0.01 and p < 0.05, compared with Sham and CLP groups, respectively). Conclusion: High dose POMx consumption prior to sepsis induction, suppressed the vital function of neutrophils in early hours after sepsis initiation, resulting in higher oxidative stress. These findings indicate that caution should be made in using high dose pomegranate products. The main message of current study is that such useful compounds as antioxidants including pomegranate juice which have beneficial effects on general health status may have detrimental effects if misused or used in high doses.

Co-ingestion of Antioxidant Drinks With an Unhealthy Challenge Meal Fails to Prevent Post-prandial Endothelial Dysfunction: An Open-Label, Crossover Study in Older Overweight Volunteers

Eating a high calorie meal is known to induce endothelial dysfunction and it is reported that consuming drinks rich in antioxidants may be protective against this. In this study we assessed the effects of three antioxidant drinks with considerable disparity in their antioxidant content on endothelial function. Seven apparently healthy overweight and older adults (BMI 25-35; mean age 57 ± 3 years; one male, six females) completed four trials in a randomized counterbalanced design. Water (control), orange juice, green tea, or red wine were consumed with a high calorie meal (>900 kcal). Endothelial function was measured by flow-mediated dilatation immediately before (fasted, baseline) and 2 h after the meal. Blood samples were also obtained for lipid and glucose analysis, plasma nitrite ( NO 2 - ) and oxidized low-density lipoprotein (ox-LDL). Participants returned after a minimum 3 days washout to complete the remaining arms of the study. The results found that the high calorie meal induced a substantial increase in triglycerides, but not cholesterol or glucose, at 2 h after meal ingestion. FMD was significantly reduced by ∼35% at this timepoint, but the effect was not attenuated by co-ingestion of any of the antioxidant drinks. Reduced FMD was mirrored by a reduction in NO 2 - , but ox-LDL was not increased at 2 h after the meal. None of the undertaken measures were influenced by the antioxidant drinks. We conclude that co-ingestion of none of our test antioxidant drinks protected against the substantial post-prandial endothelial dysfunction induced by an unhealthy meal challenge in our sample population at a 2 h timepoint.

Effect of pomegranate fruit supplementation on performance and various markers in athletes and active subjects: A systematic review

The aim of the study was to review recent findings on the use of POM supplements in athletes of various disciplines and physically active participants. Eleven articles published between 2010 and 2018 were included, where the total number of investigated subjects was 176. Male participants constituted the majority of the group (n = 155), as compared to females (n = 21). 45% of research described was conducted on athletes, whereas the remaining studies were based on highly active participants. Randomised, crossover, double-blind study designs constituted the majority of the experimental designs used. POM supplementation varied in terms of form (pills/juice), dosage (50 ml-500 ml) and time of intervention (7 days-2 months) between studies. Among the reviewed articles, POM supplementation had an effect on the improvement of the following: whole body strength; feeling of vitality; acute and delayed muscle fatigue and soreness; increase in vessel diameter; blood flow and serum level of TAC; reduction in the rate of increase for HR, SBP, CK and LDH; support in the recovery of post-training CK, LDH, CRP and ASAT to their baseline levels; reduction of MMP2, MMP9, hsCRP and MDA; and increased activity of antioxidant enzymes (glutathione peroxidase and superoxide dismutase). In the majority of reviewed articles POM supplementation had a positive effect on a variety of parameters studied and the authors recommended it as a supplement for athletes and physically active bodies.

Lactic Acid Fermentation of Pomegranate Juice as a Tool to Improve Antioxidant Activity

An increasing consumer demand for pomegranate has been globally observed, mainly thanks to the scientific evidence related to its functional and health-promoting features. Pomegranate fruits from twenty accessions identified in Southeastern Italy were characterized according to morphological and chemical features. Juices extracted from pomegranate fruits were fermented with selected Lactobacillus plantarum PU1 and the antioxidant activity investigated. Whey was added to juices to promote the microbial growth. Fermentation led to the increase of the radical scavenging activity (up to 40%) and significant inhibition of the linoleic acid peroxidation. The three fermented juices showing the highest antioxidant activity, and the corresponding unfermented controls, were further characterized. In detail, the cytotoxicity and the protective role toward artificially induced oxidative stress were determined on murine fibroblasts Balb 3T3 through the determination of the viability and the intracellular ROS (reactive oxygen species) scavenging activity (RSA). RSA reached values of ca. 70% in fermented juices, being ca. 40% higher than the unfermented and control samples. Phenols compounds of the pomegranate juices obtained from accessions "Bitonto Piscina," "Sanrà nero," and "Wonderful (reference cultivar) were analyzed through ultrahigh pressure liquid chromatography coupled with mass spectrometry, showing that a marked increase (up to 60%) of the ellagitannins derivatives occurred during fermentation. Sensory analysis showed suitability of the fermented juices to be used as beverage and food ingredient.

Immunomodulatory and antioxidant effects of pomegranate peel polysaccharides on immunosuppressed mice

This work aims to analyze the immunomodulatory effect of pomegranate peel polysaccharides (PPP) on the immunosuppressed mice induced by cyclophosphamide (CTX). All the mice were divided into 6 groups randomly and the immunoprophylaxis mice were administrated with PPP [100, 200, 400 mg/(kg·d)] by gavage for consecutive 28 days. The results showed that PPP can slow down the decline of body weight and increase the immune organ index of the immunosuppressed mice. Compared to the model mice, the enzymatic activity of LDH (lactate dehydrogenase) and ACP (acid phosphatase) of the mice spleen administrated with PPP by gavage was enhanced significantly. PPP stimulated proliferation and secretion of splenic lymphocytes and markedly increased the immunoglobulin (Ig-A, Ig-G and Ig-M) expression and the release of cytokines (TNF-α, IL-2 and INF-γ) in cyclophosphamide-induced immunosuppressed mice. Hepatic antioxidant enzymatic activities of T-AOC (total antioxidant capacity), T-SOD (total superoxide dismutase), GSH-PX (glutathione peroxidase) and CAT (catalase) were markedly increased when the mice were administrated with high dosage of PPP. So it can be concluded that PPP could be used as an efficacious adjacent immunopotentiating therapy or an alternative means in lessening chemotherapy-induced immunosuppression, and also can be utilized as immunostimulants for food and pharmaceutical industries.

Τhe Antioxidant Function of HDL in Atherosclerosis

Atherosclerosis is a multistep process that progresses over a long period of time and displays a broad range of severity. In its final form, it manifests as a lesion of the intimal layer of the arterial wall. There is strong evidence supporting that oxidative stress contributes to coronary heart disease morbidity and mortality and antioxidant high-density lipoprotein (HDL) could have a beneficial role in the prevention and prognosis of the disease. Indeed, certain subspecies of HDL may act as natural antioxidants preventing oxidation of lipids on low-density lipoprotein (LDL) and biological membranes. The antioxidant function may be attributed to inhibition of synthesis or neutralization of free radicals and reactive oxygen species by HDL lipids and associated enzymes or transfer of oxidation prone lipids from LDL and biological membranes to HDL for catabolism. A limited number of clinical trials suggest that the increased antioxidant potential of HDL correlates with decreased risk for atherosclerosis. Some nutritional interventions to increase HDL antioxidant activity have been proposed with limited success so far. The limitations in measuring and understanding HDL antioxidant function in vivo are also discussed.

Chemical changes that occur in Jerusalem artichoke silage

The effects of 10 and 20 days of fermentation followed by freeze-drying on the vitamin C and fatty acids contents, chemical conversions and overall chemical composition of Jerusalem artichoke were studied. Fermentation between the 10th and 20th days increased content of all saturated fatty acids and two of the four unsaturated fatty acids. The only fatty acid content that decreased was that of C18:1 cis 9 acid, which was suggested to be converted to other fatty acids. The experimental data, which were supported by energetical feasibility, suggested the reaction pathways of the mutual conversions of fatty acids and confirmed the decreased vitamin C content during fermentation. Discriminant modelling of the spectral data successfully distinguished the fresh, 10 days and 20 days fermented samples. The correlation of the spectral and reference data allowed to construct reference models for predicting the content of vitamin C and C18:1 cis 9 fatty acid.

Dissipation of neonicotinoid insecticides imidacloprid, indoxacarb and thiamethoxam on pomegranate (Punica granatum L.)

Neonicotinoid insecticides such as imidacloprid, indoxacarb and thiamethoxam are widely used for control of a large number of insect pests of pomegranate crop. Their residue levels were evaluated on pomegranate fruits over 2 years during the same cropping season. The QuEChERS analytical method in conjunction with LC-MS/MS was validated to analyse the insecticides on pomegranate fruits with peel (whole fruit), without peel (aril) and in the field soil. The method performance was satisfactory with the limit of quantification (LOQ) of 0.005 mg/kg which was below the maximum residue limits (MRLs) in pomegranate for the 3 compounds. A first order reaction kinetics was observed for the three insecticides with the half -life of degradation of 8-11.1 days for imidacloprid; 7.4-8.4 days for indoxacarb and 9.8-14.2 days for thiamethoxam. Though the insecticides are systemic in nature, the residues in the edible pomegranate aril were always < LOQ. The maximum residue levels of imidacloprid on pomegranate was less than its MRL of 1 mg/kg, so the pre-harvest interval (PHI) required was 1 day only. For indoxacarb, 31-42 days PHI was needed for the residues to reduce to its MRL of 0.02 mg/kg. The PHI of thiamethoxam was 46-77 days, the time required for its residues to reduce to its MRL of 0.01 mg/kg. Higher rainfall possibly facilitated faster dissipation of imidacloprid residues from pomegranate whereas indoxacarb and thiamethoxam remained unaffected. The results of the study can be utilized to incorporate these three chemicals in the plant protection program of pomegranate and fixation of MRL in India.

Does pomegranate consumption affect weight and body composition? A systematic review and meta-analysis of randomized controlled clinical trials

Pomegranate is rich in tannins, polyphenols, flavonoids, and several other types of antioxidant compounds whose role in weight loss has been shown in previous studies. However, the results have been mixed regarding the effects of pomegranate consumption on weight loss. Electronic databases such as PubMed, Scopus, ISI Web of Science, and Google Scholar were systematically searched up to May 2018 for controlled clinical trials assessing the effect of pomegranate consumption on weight loss. A random effects model was used to calculate the weighted mean difference (WMD) and 95% confidence interval (CI) as the difference between the mean for the intervention and control groups. Thirteen randomized controlled trials (including 513 participants) were included in the present meta-analysis. Compared with the control groups, there was no significant reduction in bodyweight, body mass index, waist circumference, and body fat percentage after pomegranate consumption (WMD = -0.23 kg, 95% CI: -0.94, 0.47, P = 0.515; WMD = -0.12 kg/m² , 95% CI: -0.29, 0.03, P = 0.132; WMD = -0.08 cm, 95% CI: -0.33, 0.17, P = 0.534; WMD = -0.05, 95% CI: -1.66, 1.55, P = 0.947, respectively). According to the results of the present systematic review and meta-analysis, there was no significant effect of pomegranate consumption on weight and body composition indices.

Supplementation with Hydroxytyrosol and Punicalagin Improves Early Atherosclerosis Markers Involved in the Asymptomatic Phase of Atherosclerosis in the Adult Population: A Randomized, Placebo-Controlled, Crossover Trial

Hydroxytyrosol (HT) and Punicalagin (PC) exert cardioprotective and anti-atherosclerotic effects. This study evaluates the effect of oral supplementation with HT and PC (SAx) on early atherosclerosis markers in middle-aged, seemingly healthy adults. A randomized, double-blinded, placebo-controlled, crossover trial was performed for 20 weeks. There were two treatment sequences (Placebo/SAx, n = 41; SAx/Placebo, n = 43) for which the intervention periods (Placebo and SAx) were 8 weeks long, followed by a 4-week wash out period. The supplement was composed of 9.9 mg of HT and 195 mg of PC, and the placebo was composed of maltodextrin. SAx increased endothelial function (Flow-mediated dilatation [FMD]: 2.36%; p < 0.001) in the endothelial dysfunction subgroup compared to the placebo (2.36 ± 3.9 vs. 0.76 ± 3.5%, p < 0.05). SAx also reduced oxLDL by -28.74 ng/mL (p < 0.05) in subjects with higher levels of oxLDL, which was an improvement compared with the placebo (-28.74 ± 40.2 vs. 25.64 ± 93.8 ng/mL, p < 0.001). The prehypertension and hypertension subgroups exhibited decreased systolic (-15.75 ± 9.9 mmHg; p < 0.001) and diastolic (-6.36 ± 8.7 mmHg; p < 0.001) blood pressure after SAx consumption. Moreover, the systolic prehypertension and hypertension subgroups presented significant differences in systolic blood pressure compared to the placebo (-15.75 ± 9.9 vs. -2.67 ± 12.0 mmHg, p < 0.05). In conclusion, the supplement exerted anti-atherosclerotic effects by improving endothelial function, blood pressure, and levels of circulating oxLDL, especially for persons in whom these parameters were altered.

The Role of Traditional Chinese Medicine in the Regulation of Oxidative Stress in Treating Coronary Heart Disease

Oxidative stress has been closely related with coronary artery disease. In coronary heart disease (CHD), an excess of reactive oxygen species (ROS) production generates endothelial cell and smooth muscle functional disorders, leading to a disequilibrium between the antioxidant capacity and prooxidants. ROS also leads to inflammatory signal activation and mitochondria-mediated apoptosis, which can promote and increase the occurrence and development of CHD. There are several kinds of antioxidative and small molecular systems of antioxidants, such as β-carotene, ascorbic acid, α-tocopherol, and reduced glutathione (GSH). Studies have shown that antioxidant treatment was effective and decreased the risk of CHD, but the effect of the treatment varies greatly. Traditional Chinese medicine (TCM) has been utilized for thousands of years in China and is becoming increasingly popular all over the world, especially for the treatments of cardiovascular diseases. This review will concentrate on the evidence of the action mechanism of TCM in preventing CHD by modulating oxidative stress-related signaling pathways.

Semen quality of preserved buffalo semen extended in tris extender with processed yolk enriched with strawberry juice (Fragaria spp.)

Strawberry fruit is rich in natural antioxidants supplemented as a preservative in semen extenders. There is little literature regarding its application in cattle bulls. So, the aim of the present study was to explore the impact of strawberry juice beside LDL derived from egg yolk on buffalo spermatozoa during cooling and cryopreservation. Collected semen was pooled to be divided in aliquots. Semen was diluted in tris-Citrate-Fructose-yolk low-density lipoprotein (TLCF) (control, 0% strawberry juice (SB)) and in six different concentrations (1-6%) of tris-LDL-strawberry diluent (TLSB) to ensure 60 million motile spermatozoa/mL. The cooled diluted semen in 0.25-mL polyvinyl French straws were processed and cryopreserved in liquid nitrogen (LN₂). Extended semen was evaluated (motility %, alive %, abnormality %, and normal sperm membrane (HOST) %) in the preserved semen. Data output revealed that sperm motility of post-chilled spermatozoa improved on adding strawberry concentrations 3 and 4% in TLCF extender. In frozen semen, SB concentration 1 and 2% gave the best significance (P < 0.0014) sperm motility relative to the control. With respect to the alive sperm percent, the majority of the concentrations used showed significant higher alive sperm relative to the control. The sperm abnormalities was significant (P < 0.0001) lower in most of the supplemented concentrations relative to the control. HOST percentage was kept in every concentration. It could be concluded that enrichment of 1-4% strawberry juice in tris-LDL extender improved semen quality post-cooling and post-freezing.

Effects of pomegranate juice consumption on blood pressure and lipid profile in patients with type 2 diabetes: A single-blind randomized clinical trial

Pomegranate juice (PJ) has abundant anti-oxidative polyphenolic compounds which are assumed to have cardioprotective effects such as hypotensive properties. This study aimed to investigate the effects of PJ consumption on blood pressure and lipid profile F variables in patients with type 2 diabetes. Sixty subjects (30 in intervention group and 30 in control group) were recruited in this single-blind placebo-controlled randomized clinical trial. The volunteers were randomly assigned to one of two groups. Treatment group consumed 200 ml/day PJ for 6 weeks, while control group received no intervention. Systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations were measured following 12-14 h of fasting at baseline and at the end of the study. After 6 weeks of intervention, SBP (13.5 ± 1.5 mmHg vs. 12.3 ± 2.5, P < 0.001) and DBP (7.7 ± 1.6 vs. 7.2 ± 1.6 mmHg, P < 0.05) significantly decreased in the intervention group. Similarly, SBP and DBP in the intervention group were significantly lower than the control group after intervention (P < 0.02 and P < 0.03, respectively). At the end of the intervention, TC, TG, LDL-C and HDL-C did not significantly differ between the intervention group and the control group however, TC and LDL-C decreased significantly compared to pre-trial values within the intervention group. It is concluded that PJ consumption could decrease systolic and diastolic blood pressure in patients with diabetes while having no effect on lipid profile. A more definitive result will be obtained if future studies could conducted in hyperlipidemic individuals who might be more prone to respond to the lipid-lowering effects.

Exogenous (Pomegranate Juice) or Endogenous (Paraoxonase1) Antioxidants Decrease Triacylglycerol Accumulation in Mouse Cardiovascular Disease-Related Tissues

The polyphenol-rich pomegranate juice (PJ) and the high-density lipoprotein (HDL)-associated paraoxonase1 (PON1) are known as potent atheroprotective antioxidants, but their effects on other tissues related to cardiovascular disease (CVD) remain unknown. The current study aimed to investigate the effects of treating mice with PJ or recombinant PON1 (rePON1) on the oxidation and lipid status of CVD-related tissues: serum, aorta, heart, liver, kidney, visceral, and subcutaneous adipose tissues (VAT and SAT). Both PJ consumption and rePON1 injection decreased the serum levels of thiobarbituric acid-reactive substances (16% and 19%) and triacylglycerols (TAG, 24% and 27%), while only rePON1 increased the levels of thiol groups (35%) and decreased serum cholesterol (15%). Both PJ and rePON1 significantly decreased aortic cholesterol (38% and 32%) and TAG (62% and 58%) contents in association with downregulation of the key TAG biosynthetic enzyme diacylglycerol O-acyltransferase 1 (DGAT1, 71% and 65%), while only PJ decreased aortic lipid peroxides (47%). Substantial TAG-lowering effects of both PJ and rePON1 were observed also in the heart (31% and 42%), liver (34% and 42%), and kidney (42% and 57%). In both VAT and SAT, rePON1 decreased the levels of lipid peroxides (28% and 25%), while PJ decreased the TAG content (22% and 18%). Ex vivo incubation of SAT with serum derived from mice that consumed PJ or injected with rePON1 decreased SAT lipid peroxides (35% or 28%) and TAG mass (12% or 10%). These novel findings highlight potent TAG-lowering properties of exogenous (PJ) and endogenous (PON1) antioxidants in tissues associated with CVD.

The lipid peroxidation in patients with nephrolithiasis before and after extracorporeal shock wave lithotripsy

AIM

To evaluate the level of lipid peroxidation in patients with nephrolithiasis before and after extracorporeal shock wave lithotripsy (ESWL).

MATERIALS & METHODS

Isoprostane concentration (8-isoPGF_2α) was measured in urine, and thiobarbituric acid reactive substance production in serum and erythrocytes. In addition, the concentrations of selected compounds (uric acid, glucose and creatinine) were measured in serum.

RESULTS

The patients (before and after ESWL) demonstrated significantly higher levels of two different biomarkers of lipid peroxidation compared with the control group. A correlation was identified between increased amounts of uric acid and biomarkers of lipid peroxidation in patients with nephrolithiasis, both before and after ESWL.

CONCLUSION

Uric acid may be associated with lipid peroxidation in patients with nephrolithiasis.

Alleviation of Cyclophosphamide-induced Hemorrhagic Cystitis by Dietary Pomegranate: A Comparative Experimental Study With Mesna

In this study, we investigated the effects of pomegranate on alleviating cyclophosphamide-induced hemorrhagic cystitis (HC). Initially, 16 Sprague-Dawley rats were allocated into 4 groups: group 1 (control), group 2 (CP) in which HC was induced by cyclophosphamide; group 3 (CP+M), HC-induced rats that received Mesna regimen, and group 4 (CP+P), which compromised rats that had been on a 14-day diet of pomegranate juice before HC induction. Cystometry was performed a few hours before euthanasia; after euthanasia, aortic blood samples and bladder tissue samples were obtained to perform TUNEL assay, and histopathologic and biochemical assessments. Urodynamic findings revealed that mean detrusor pressure in CP+P was significantly lower compared with that in CP and CP+M (P<0.05). Histopathologically, urothelium destruction and inflammation were lower in CP+P and CP+M compared with that in CP. Collagen destruction was less prominent in CP+P compared with that in CP and CP+M. Tissue and plasma levels of malondialdehyde were significantly lower in CP+P versus CP (P<0.05). Catalase activity and total protein thiol group levels in plasma and bladder tissue were higher in CP+P versus CP (P<0.05). The TUNEL positivity in CP+P was significantly weaker than that in CP, indicating less DNA fragmentation and apoptosis. Pomegranate's characteristics could significantly affect the inflammatory and destructive process of hemorrhagic cystitis.

Effects of pomegranate supplementation on exercise performance and post-exercise recovery in healthy adults: a systematic review

The functional significance of pomegranate (POM) supplementation on physiological responses during and following exercise is currently unclear. This systematic review aimed (i) to evaluate the existing literature assessing the effects of POM supplementation on exercise performance and recovery; exercise-induced muscle damage, oxidative stress, inflammation; and cardiovascular function in healthy adults and (ii) to outline the experimental conditions in which POM supplementation is more or less likely to benefit exercise performance and/or recovery. Multiple electronic databases were used to search for studies examining the effects of POM intake on physiological responses during and/or following exercise in healthy adult. Articles were included in the review if they investigated the effects of an acute or chronic POM supplementation on exercise performance, recovery and/or physiological responses during or following exercise. The existing evidence suggests that POM supplementation has the potential to confer antioxidant and anti-inflammatory effects during and following exercise, to improve cardiovascular responses during exercise, and to enhance endurance and strength performance and post-exercise recovery. However, the beneficial effects of POM supplementation appeared to be less likely when (i) unilateral eccentric exercise was employed, (ii) the POM administered was not rich in polyphenols (<1·69 g/l) and (iii) insufficient time was provided between POM-ingestion and the assessment of physiological responses/performance (≤1 h). The review indicates that POM has the potential to enhance exercise performance and to expedite recovery from intensive exercise. The findings and recommendations from this review may help to optimise POM-supplementation practice in athletes and coaches to potentially improve exercise-performance and post-exercise recovery.