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Jacquier EF, Kassis A, Marcu D, Contractor N, Hong J, Hu C, Kuehn M, Lenderink C, Rajgopal A. Phytonutrients in the promotion of healthspan: a new perspective. Front Nutr 2024; 11:1409339. [PMID: 39070259 PMCID: PMC11272662 DOI: 10.3389/fnut.2024.1409339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/12/2024] [Indexed: 07/30/2024] Open
Abstract
Considering a growing, aging population, the need for interventions to improve the healthspan in aging are tantamount. Diet and nutrition are important determinants of the aging trajectory. Plant-based diets that provide bioactive phytonutrients may contribute to offsetting hallmarks of aging and reducing the risk of chronic disease. Researchers now advocate moving toward a positive model of aging which focuses on the preservation of functional abilities, rather than an emphasis on the absence of disease. This narrative review discusses the modulatory effect of nutrition on aging, with an emphasis on promising phytonutrients, and their potential to influence cellular, organ and functional parameters in aging. The literature is discussed against the backdrop of a recent conceptual framework which describes vitality, intrinsic capacity and expressed capacities in aging. This aims to better elucidate the role of phytonutrients on vitality and intrinsic capacity in aging adults. Such a review contributes to this new scientific perspective-namely-how nutrition might help to preserve functional abilities in aging, rather than purely offsetting the risk of chronic disease.
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Affiliation(s)
| | | | - Diana Marcu
- School of Molecular Biosciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Jina Hong
- Amway Innovation and Science, Ada, MI, United States
| | - Chun Hu
- Amway Innovation and Science, Ada, MI, United States
| | - Marissa Kuehn
- Amway Innovation and Science, Ada, MI, United States
| | | | - Arun Rajgopal
- Amway Innovation and Science, Ada, MI, United States
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2
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Osakabe N, Shimizu T, Fujii Y, Fushimi T, Calabrese V. Sensory Nutrition and Bitterness and Astringency of Polyphenols. Biomolecules 2024; 14:234. [PMID: 38397471 PMCID: PMC10887135 DOI: 10.3390/biom14020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Recent studies have demonstrated that the interaction of dietary constituents with taste and olfactory receptors and nociceptors expressed in the oral cavity, nasal cavity and gastrointestinal tract regulate homeostasis through activation of the neuroendocrine system. Polyphenols, of which 8000 have been identified to date, represent the greatest diversity of secondary metabolites in plants, most of which are bitter and some of them astringent. Epidemiological studies have shown that polyphenol intake contributes to maintaining and improving cardiovascular, cognitive and sensory health. However, because polyphenols have very low bioavailability, the mechanisms of their beneficial effects are unknown. In this review, we focused on the taste of polyphenols from the perspective of sensory nutrition, summarized the results of previous studies on their relationship with bioregulation and discussed their future potential.
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Affiliation(s)
- Naomi Osakabe
- Functional Control Systems, Graduate School of Engineering and Science, Shibaura Institute of Technology, Tokyo 135-8548, Japan
- Systems Engineering and Science, Graduate School of Engineering and Science, Shibaura Institute of Technology, Tokyo 135-8548, Japan;
- Department of Bio-Science and Engineering, Faculty of System Science and Engineering, Shibaura Institute of Technology, Tokyo 135-8548, Japan; (T.S.); (Y.F.)
| | - Takafumi Shimizu
- Department of Bio-Science and Engineering, Faculty of System Science and Engineering, Shibaura Institute of Technology, Tokyo 135-8548, Japan; (T.S.); (Y.F.)
| | - Yasuyuki Fujii
- Department of Bio-Science and Engineering, Faculty of System Science and Engineering, Shibaura Institute of Technology, Tokyo 135-8548, Japan; (T.S.); (Y.F.)
| | - Taiki Fushimi
- Systems Engineering and Science, Graduate School of Engineering and Science, Shibaura Institute of Technology, Tokyo 135-8548, Japan;
| | - Vittorio Calabrese
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy;
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3
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Iqbal I, Wilairatana P, Saqib F, Nasir B, Wahid M, Latif MF, Iqbal A, Naz R, Mubarak MS. Plant Polyphenols and Their Potential Benefits on Cardiovascular Health: A Review. Molecules 2023; 28:6403. [PMID: 37687232 PMCID: PMC10490098 DOI: 10.3390/molecules28176403] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Fruits, vegetables, and other food items contain phytochemicals or secondary metabolites which may be considered non-essential nutrients but have medicinal importance. These dietary phytochemicals exhibit chemopreventive and therapeutic effects against numerous diseases. Polyphenols are secondary metabolites found in vegetables, fruits, and grains. These compounds exhibit several health benefits such as immune modulators, vasodilators, and antioxidants. This review focuses on recent studies on using dietary polyphenols to treat cardiovascular disorders, atherosclerosis, and vascular endothelium deficits. We focus on exploring the safety of highly effective polyphenols to ensure their maximum impact on cardiac abnormalities and discuss recent epidemiological evidence and intervention trials related to these properties. Kaempferol, quercetin, and resveratrol prevent oxidative stress by regulating proteins that induce oxidation in heart tissues. In addition, polyphenols modulate the tone of the endothelium of vessels by releasing nitric oxide (NO) and reducing low-density lipoprotein (LDL) oxidation to prevent atherosclerosis. In cardiomyocytes, polyphenols suppress the expression of inflammatory markers and inhibit the production of inflammation markers to exert an anti-inflammatory response. Consequently, heart diseases such as strokes, hypertension, heart failure, and ischemic heart disease could be prevented by dietary polyphenols.
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Affiliation(s)
- Iram Iqbal
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Fatima Saqib
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Bushra Nasir
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan;
| | - Muqeet Wahid
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
| | - Muhammad Farhaj Latif
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
| | - Ahmar Iqbal
- Department of General Surgery, Shanxi Medical University, Jinzhong 030600, China;
| | - Rabia Naz
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
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4
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Gröne M, Duse DA, Kramser N, Ophoff N, Schweers H, Voß F, Quast C, Sansone R, Heiss C, Jung C, Kelm M, Erkens R. Cocoa flavanols improve peakVO 2 and exercise capacity in a randomized double blinded clinical trial in healthy elderly people. Food Funct 2023; 14:7562-7573. [PMID: 37526943 DOI: 10.1039/d3fo01737k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Background: Loss of functional capacity is one of the hallmarks in cardiovascular aging. Cocoa flavanols (CF) exert favorable effects on endothelial function, blood pressure, and inflammation. These cardiovascular health markers worsen with increasing age and limit functional exercise capacity. Aim: To investigate the effect of CF on cardiorespiratory-fitness in healthy elderly people. Methods: In a randomized, double-masked, placebo-controlled, parallel-group dietary intervention trial, 68 healthy elderly people (55-79 years, 28 female) received either 500 mg of CF or a nutrient-matched control capsule twice a day for 30 days. Primary endpoint was defined as peak oxygen consumption (VO2) in a cardiopulmonary exercise test (CPET). Secondary endpoints were oxygen pulse (VO2 per heart rate (HR)), resting blood pressure (BP), and resting vascular function. Results: After 30 days of CF intake peakVO2 increased by 190 ml min-1 (95% CI 1-371 ml min-1) and peakVO2 per kg by 2.5 ml (min kg)-1 (95% CI 0.30-4.2 ml (min kg)-1). O2-pulse increased by 1.7 ml (95% CI 0.29-3.2 ml) and max exercise capacity by 9.6 W (95% CI 2.1-17.7 W). CF decreased resting systolic and diastolic BP by 5.4 mmHg (95% CI -10.7 to -0.1 mmHg) and 2.9 mmHg (95% CI -5.5 to -0.4 mmHg), respectively. Flow-mediated vasodilation (FMD) increased by an absolute 1.3% (95% CI 0.76-1.79%) in the CF group. Indexes of pulmonary function were not affected. No changes for primary and secondary endpoints were detected in control. Conclusion: CF substantially improve markers of cardiorespiratory fitness in healthy elderly humans highlighting their potential to preserve cardiovascular health with increasing age.
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Affiliation(s)
- Michael Gröne
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Dragos Andrei Duse
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Nicolas Kramser
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Niklas Ophoff
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Hendrik Schweers
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Fabian Voß
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Christine Quast
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Roberto Sansone
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Christian Heiss
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, UK
| | - Christian Jung
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
- CARID, Cardiovascular Research Institute Düsseldorf, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
| | - Ralf Erkens
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
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Kiyimba T, Yiga P, Bamuwamye M, Ogwok P, Van der Schueren B, Matthys C. Efficacy of Dietary Polyphenols from Whole Foods and Purified Food Polyphenol Extracts in Optimizing Cardiometabolic Health: A Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2023; 14:270-282. [PMID: 36796437 DOI: 10.1016/j.advnut.2023.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/17/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
The evidence from clinical trials concerning the efficacy of dietary polyphenols on cardiometabolic health is divergent. Therefore, this review aimed to determine the pooled effect of dietary polyphenols on cardiometabolic risk markers and compare the difference in efficacy between whole polyphenol-rich foods and purified food polyphenol extracts. We conducted a random-effect model meta-analysis of randomized controlled trials (RCTs) on the effect of polyphenols on blood pressure, lipid profile, flow-mediated dilation (FMD), fasting blood glucose (FBG), waist circumference, and markers of inflammation. Effect size was expressed as weighted mean difference and 95% CI. RCTs published in English between 2000 and 2021 involving adult participants with cardiometabolic risks were searched in electronic databases. Forty-six RCTs involving 2494 participants with a mean age of 53.3 ±10 y were included in this review. Whole polyphenol-rich food but not purified food polyphenol extracts significantly reduced systolic blood pressure (SBP, -3.69 mmHg; 95% CI: -4.24, -3.15 mmHg; P = 0.00001) and diastolic blood pressure (DBP, -1.44 mmHg; 95% CI: -2.56, -0.31 mmHg; P = 0.0002). Concerning waist circumference, purified food polyphenol extracts led to a larger effect (-3.04 cm; 95% CI: -7.06, -0.98 cm; P = 0.14). Significant effects on total cholesterol (-9.03 mg/dL; 95% CI: -16.46, -1.06 mg/dL; P = 0.02) and TGs (-13.43 mg/dL; 95% CI: -23.63, -3.23; P = 0.01) were observed when purified food polyphenol extracts were considered separately. None of the intervention materials significantly affected LDL-cholesterol, HDL-cholesterol, FBG, IL-6, and CRP. When both whole food and extracts were pooled together, there was a significant reduction in SBP, DBP, FMD, TGs, and total cholesterol. These findings suggest that polyphenols both as whole food and purified extracts can be efficacious in reducing cardiometabolic risks. However, these results must be interpreted with caution because of high heterogeneity and risk of bias among RCTs. This study was registered on PROSPERO as CRD42021241807.
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Affiliation(s)
- Tonny Kiyimba
- Department of Food Science and Technology, Kyambogo University, Kampala, Uganda; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Peter Yiga
- Department of Food Science and Technology, Kyambogo University, Kampala, Uganda; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Michael Bamuwamye
- Department of Food Science and Technology, Kyambogo University, Kampala, Uganda
| | - Patrick Ogwok
- Department of Food Science and Technology, Kyambogo University, Kampala, Uganda
| | - Bart Van der Schueren
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
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6
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Stadelmaier J, Roux I, Petropoulou M, Schwingshackl L. Empirical evidence of study design biases in nutrition randomised controlled trials: a meta-epidemiological study. BMC Med 2022; 20:330. [PMID: 36217133 PMCID: PMC9552513 DOI: 10.1186/s12916-022-02540-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Instruments to critically appraise randomised controlled trials (RCTs) are based on evidence from meta-epidemiological studies. We aim to conduct a meta-epidemiological study on the average bias associated with reported methodological trial characteristics such as random sequence generation, allocation concealment, blinding, incomplete outcome data, selective reporting, and compliance of RCTs in nutrition research. METHODS We searched the Cochrane Database of Systematic Reviews, for systematic reviews of RCTs, published between 01 January 2010 and 31 December 2019. We combined the estimates of the average bias (e.g. ratio of risk ratios [RRR] or differences in standardised mean differences) in meta-analyses using the random-effects model. Subgroup analyses were conducted to investigate the potential differences among the RCTs with low versus high/unclear risk of bias with respect to the different types of interventions (e.g. micronutrients, fatty acids, dietary approach), outcomes (e.g. mortality, pregnancy outcomes), and type of outcome (objective, subjective). Heterogeneity was assessed through I2 and τ2, and prediction intervals were calculated. RESULTS We included 27 Cochrane nutrition reviews with 77 meta-analyses (n = 927 RCTs). The available evidence suggests that intervention effect estimates may not be exaggerated in RCTs with high/unclear risk of bias (versus low) judgement for sequence generation (RRR 0.97, 95% CI 0.93 to 1.02; I2 = 28%; τ2 = 0.002), allocation concealment (RRR 1.00, 95% CI 0.96 to 1.04; I2 = 27%; τ2 = 0.001), blinding of participants and personnel (RRR 0.95, 95% CI 0.91 to 1.00; I2 = 23%; τ2 = 0), selective reporting (RRR 0.97, 95% CI 0.92 to 1.02; I2 = 24%; τ2 = 0), and compliance (RRR 0.95, 95% CI 0.89 to 1.02; I2 = 0%; τ2 = 0). Intervention effect estimates seemed to be exaggerated in RCTs with a high/unclear risk of bias judgement for blinding of outcome assessment (RRR 0.81, 95% CI 0.70 to 0.94; I2 = 26%; τ2 = 0.03), which was predominately driven by subjective outcomes, and incomplete outcome data (RRR 0.92, 95% CI 0.88 to 0.97; I2 = 22%; τ2 = 0.001). For continuous outcomes, no differences were observed, except for selective reporting. CONCLUSIONS On average, most characteristics of nutrition RCTs may not exaggerate intervention effect estimates, but the average bias appears to be greatest in trials of subjective outcomes. Replication of this study is suggested in this field to keep this conclusion updated.
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Affiliation(s)
- Julia Stadelmaier
- Institute for Evidence in Medicine, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Isabelle Roux
- Institute for Evidence in Medicine, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maria Petropoulou
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre, University of Freiburg, Freiburg, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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7
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Borghi C, Fogacci F, Agnoletti D, Cicero AFG. Hypertension and Dyslipidemia Combined Therapeutic Approaches. High Blood Press Cardiovasc Prev 2022; 29:221-230. [PMID: 35334087 PMCID: PMC9050771 DOI: 10.1007/s40292-022-00507-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/11/2022] [Indexed: 12/11/2022] Open
Abstract
Treating blood pressure (BP) alone may provide only limited benefits while it is recommendable to manage the total cardiovascular risk. To date, several studies have shown that concomitant treatment of hypertension and dyslipidemia with non-pharmacological approaches and/or metabolically neutral antihypertensive drugs and statins produce a significantly greater reduction of the risk of developing cardiovascular disease. Thus, in this review article, we summarize the available evidence regarding non-pharmacological and pharmacological approaches with a favourable effect on both BP and lipids.
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Affiliation(s)
- Claudio Borghi
- Medical and Surgical Sciences Department, Hypertension and Cardiovascular Risk Factors Research Center, Sant'Orsola-Malpighi University Hospital, U.O. Medicina Interna Cardiovascolare, Alma Mater Studiorum University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy. .,IRCCS AOU S. Orsola-Malpighi, Bologna, Italy.
| | - Federica Fogacci
- Medical and Surgical Sciences Department, Hypertension and Cardiovascular Risk Factors Research Center, Sant'Orsola-Malpighi University Hospital, U.O. Medicina Interna Cardiovascolare, Alma Mater Studiorum University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy.,IRCCS AOU S. Orsola-Malpighi, Bologna, Italy
| | - Davide Agnoletti
- Medical and Surgical Sciences Department, Hypertension and Cardiovascular Risk Factors Research Center, Sant'Orsola-Malpighi University Hospital, U.O. Medicina Interna Cardiovascolare, Alma Mater Studiorum University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy.,IRCCS AOU S. Orsola-Malpighi, Bologna, Italy
| | - Arrigo F G Cicero
- Medical and Surgical Sciences Department, Hypertension and Cardiovascular Risk Factors Research Center, Sant'Orsola-Malpighi University Hospital, U.O. Medicina Interna Cardiovascolare, Alma Mater Studiorum University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy.,IRCCS AOU S. Orsola-Malpighi, Bologna, Italy
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8
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Wang L, Gao M, Kang G, Huang H. The Potential Role of Phytonutrients Flavonoids Influencing Gut Microbiota in the Prophylaxis and Treatment of Inflammatory Bowel Disease. Front Nutr 2021; 8:798038. [PMID: 34970585 PMCID: PMC8713745 DOI: 10.3389/fnut.2021.798038] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/25/2021] [Indexed: 12/19/2022] Open
Abstract
Inflammatory bowel disease (IBD), characterized by the chronic inflammation of the gastrointestinal tract, is comprised of two idiopathic chronic intestinal inflammatory diseases. As the incidence of IBD increases, so does the need for safe and effective treatments. Trillions of microorganisms are colonized in the mammalian intestine, coevolve with the host in a symbiotic relationship. Gut microbiota has been reported to be involved in the pathophysiology of IBD. In this regard, phytonutrients flavonoids have received increasing attention for their anti-oxidant and anti-inflammatory activities. In this review, we address recent advances in the interactions among flavonoids, gut microbiota, and IBD. Moreover, their possible potential mechanisms of action in IBD have been discussed. We conclude that there is a complex interaction between flavonoids and gut microbiota. It is expected that flavonoids can change or reshape the gut microbiota to provide important considerations for developing treatments for IBD.
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Affiliation(s)
- Lina Wang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, China
- Frontiers Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering, Ministry of Education, Tianjin University, Tianjin, China
| | - Mengxue Gao
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, China
- Frontiers Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering, Ministry of Education, Tianjin University, Tianjin, China
| | - Guangbo Kang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, China
- Frontiers Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering, Ministry of Education, Tianjin University, Tianjin, China
| | - He Huang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, China
- Frontiers Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering, Ministry of Education, Tianjin University, Tianjin, China
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9
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Atucha NM, Romecín P, Vargas F, García-Estañ J. Effects of flavonoids in experimental models of arterial hypertension. Curr Top Med Chem 2021; 22:735-745. [PMID: 34749613 DOI: 10.2174/1568026621666211105100800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 11/22/2022]
Abstract
Flavonoids are a class of substances of a vegetal origin with many interesting actions from the point of view of human disease. Interest in flavonoids in the diet has increased in recent years due to the publication of basic, clinical and epidemiological studies that have shown a whole array of salutory effects related to intake of flavonols and flavones as well as a lower morbility and mortality of cardiovascular diseases. Since arterial hypertension is the most common modifiable risk factor for cardiovascular diseases, this review will focus mainly on the effects of flavonoids on the cardiovascular system with relation to the elevation of blood pressure. Its antihypertensive effects as well as the many investigations performed in experimental models of arterial hypertension are reviewed in this mini-review.
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Affiliation(s)
- Noemi M Atucha
- Departmento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, and Granada. Spain
| | - Paola Romecín
- Departmento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, and Granada. Spain
| | - Felix Vargas
- Departmento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, and Granada. Spain
| | - Joaquin García-Estañ
- Departmento de Fisiología, Facultad de Medicina, Instituto Murciano de Investigación Biomédica, Universidad de Murcia, Murcia, and Granada. Spain
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10
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Zielinsky P, Martignoni FV, Markoski M, Zucatti KP, Dos Santos Marinho G, Pozzobon G, Magno PR, de Bittencourt Antunes V, Sulis NM, Cardoso A, Mattos D, Naujorks AA, von Frankenberg AD, Vian I. Maternal ingestion of cocoa causes constriction of fetal ductus arteriosus in rats. Sci Rep 2021; 11:9929. [PMID: 33976258 PMCID: PMC8113492 DOI: 10.1038/s41598-021-89309-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/20/2021] [Indexed: 01/13/2023] Open
Abstract
Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section. Immediately after withdrawal, every thorax was obtained and tissues were fixed and stained for histological analysis. The ratio of the narrowest part of the pulmonary artery to the fetal ductus inner diameter and increased ductal inner wall thickness characterized ductal constriction. Substances reactive to thiobarbituric acid were quantified. Statistical analysis used ANOVA and Tukey test. Cocoa (n = 33) and indomethacin (n = 7) reduced fetal internal ductus diameter when compared to control (water, n = 25) (p < 0.001) and cocoa alone increased ductus wall thickness (p < 0.001), but no change was noted in enzymes activity. This pharmacological study shows supporting evidences that there is a cause and effect relationship between maternal consumption of cocoa and fetal ductus arteriosus constriction. Habitual widespread use of chocolate during gestation could account for undetected ductus constriction and its potentially severe consequences, such as perinatal pulmonary hypertension, cardiac failure and even death. For this reason, dietary guidance in late pregnancy to avoid high chocolate intake, to prevent fetal ductal constriction, may represent the main translational aspect of this study.
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Affiliation(s)
- Paulo Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil. .,Departament of Pediatrics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. .,Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 395 - Santana, Porto Alegre, CEP 90620-000, Brazil.
| | - Felipe Villa Martignoni
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil.,Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Melissa Markoski
- Basic Health Science, Federal University of Health Sciences of Porto Alegre, Avenida Sarmento Leite, 245, Porto Alegre, CEP 90050-170, Brazil
| | - Kelly Pozzer Zucatti
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Gabriela Dos Santos Marinho
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Gabriela Pozzobon
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Pedro Rafael Magno
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | | | - Natassia Miranda Sulis
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Alexandra Cardoso
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Daniel Mattos
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Alexandre Antônio Naujorks
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Anize Delfino von Frankenberg
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Izabele Vian
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
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11
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Dębski H, Wiczkowski W, Horbowicz M. Effect of Elicitation with Iron Chelate and Sodium Metasilicate on Phenolic Compounds in Legume Sprouts. Molecules 2021; 26:molecules26051345. [PMID: 33802449 PMCID: PMC7959454 DOI: 10.3390/molecules26051345] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023] Open
Abstract
Seven-day-old sprouts of fenugreek (Trigonella foenum-graecum L.), lentil (Lens culinaris L.), and alfalfa (Medicagosativa L.) were studied. The legume seeds and then sprouts were soaked each day for 30 min during 6 days with water (control) or mixture of Fe-EDTA and sodium silicate (Optysil), or sodium silicate (Na-Sil) alone. Germination and sprout growing was carried out at temperature 20 ± 2 °C in 16/8 h (day/night) conditions. Phenolic compounds (free, ester, and glycosides) content were determined by HPLC-ESI-MS/MS using a multiple reaction monitoring of selected ions. Flavonoids and phenolic acids were released from their esters after acid hydrolysis and from glycosides by alkaline hydrolysis. The presence and high content of (−)-epicatechin (EC) in fenugreek sprouts was demonstrated for the first time. Applied elicitors decreased the level of free EC in fenugreek and alfalfa sprouts but enhanced the content of its esters. Besides, elicitors decreased the content of quercetin glycosides in lentil and fenugreek sprouts but increased the content of quercetin and apigenin glycosides in alfalfa sprouts. The applied elicitors decreased the glycoside levels of most phenolic acids in lentil and p-hydroxybenzoic acid in fenugreek, while they increased the content of this acid in alfalfa. The mixture of iron chelate and sodium silicate had less effect on changes in flavonoid and phenolic acid content in legume sprouts than silicate alone. In general, the used elicitors increased the content of total phenolic compounds in fenugreek and alfalfa sprouts and decreased the content in lentil sprouts. Among the evaluated elicitors, Optysil seems to be worth recommending due to the presence of iron chelate, which can be used to enrich sprouts with this element.
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Affiliation(s)
- Henryk Dębski
- Faculty of Exact and Natural Sciences, Institute of Biological Sciences, Siedlce University of Natural Sciences and Humanities, Prusa 14, 08-110 Siedlce, Poland;
| | - Wiesław Wiczkowski
- Department of Chemistry and Biodynamics of Food, Institute of Animal Reproduction and Food Research of the Polish Academy of Sciences, Tuwima 10, 10-748 Olsztyn, Poland;
| | - Marcin Horbowicz
- Faculty of Exact and Natural Sciences, Institute of Biological Sciences, Siedlce University of Natural Sciences and Humanities, Prusa 14, 08-110 Siedlce, Poland;
- Correspondence: ; Tel.: +48-25-643-1232
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12
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Martín MA, Goya L, de Pascual-Teresa S. Effect of Cocoa and Cocoa Products on Cognitive Performance in Young Adults. Nutrients 2020; 12:nu12123691. [PMID: 33265948 PMCID: PMC7760676 DOI: 10.3390/nu12123691] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/18/2020] [Accepted: 11/28/2020] [Indexed: 12/14/2022] Open
Abstract
Increasing evidence support a beneficial role of cocoa and cocoa products on human cognition, particularly in aging populations and patients at risk. However, thorough reviews on the efficacy of cocoa on brain processes in young adults do not exist precisely due to the limited number of studies in the matter. Thus, the aim of this study was to summarize the findings on the acute and chronic effects of cocoa administration on cognitive functions and brain health in young adults. Web of Science and PubMed databases were used to search for relevant trials. Human randomized controlled studies were selected according to PRISMA guidelines. Eleven intervention studies that involved a total of 366 participants investigating the role of cocoa on cognitive performance in children and young adults (average age ≤ 25 years old) were finally selected. Findings from individual studies confirm that acute and chronic cocoa intake have a positive effect on several cognitive outcomes. After acute consumption, these beneficial effects seem to be accompanied with an increase in cerebral blood flow or cerebral blood oxygenation. After chronic intake of cocoa flavanols in young adults, a better cognitive performance was found together with increased levels of neurotrophins. This systematic review further supports the beneficial effect of cocoa flavanols on cognitive function and neuroplasticity and indicates that such benefits are possible in early adulthood.
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13
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Christen T, Nagale S, Reinitz S, Narayanan S, Roy K, Allocco DJ, Osattin A. Using digital health technology to evaluate the impact of chocolate on blood pressure: Results from the COCOA-BP study. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2020; 1:89-96. [PMID: 35265879 PMCID: PMC8890357 DOI: 10.1016/j.cvdhj.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background High blood pressure (BP) is a major risk factor for cardiovascular disease (CVD). Consumption of dark chocolate, which is high in flavonoids that may reduce CVD risk, is an attractive intervention to reduce to BP. Additionally, the use of mobile health (mHealth) technologies (eg, telehealth, smartphones, and wearable devices) can improve outcomes in patients with CVD. Objective The purpose of this study was to investigate the impact of dark chocolate intake on BP, subject use of mHealth, and integration of mHealth into a clinical trial. Methods The COCOA-BP (ChOcolate COnsumption And Blood Pressure) study was a prospective, single-center, pre-/postintervention study that enrolled 62 healthy volunteers. The study consisted of 3 phases: smartwatch/smart BP monitor familiarization and washout from chocolate (week 1); control (week 2); and intervention (weeks 3 and 4). During the intervention phase, subjects consumed 50 g of dark chocolate per day. The primary endpoint was change in resting systolic BP between the intervention and control phases. Additional endpoints included device accuracy and correlation with physical activity. Results Mean resting systolic BP was 116.4 mm Hg before chocolate intake among 62 participants (mean age 37 years; 61% female). After chocolate intake, mean resting systolic BP was 116.0 mm Hg (difference –0.4; P = .69). These findings suggest that 2 weeks of dark chocolate intake did not reduce resting systolic BP. There was poor agreement between mHealth device and standard (nurse-performed) measurements. Conclusion In this study, short-term dark chocolate intake did not seem to reduce BP. mHealth technology shows great potential for use in clinical studies, but challenges related to device accuracy and compliance need to be addressed.
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Affiliation(s)
| | - Sandra Nagale
- Boston Scientific Corporation, Marlborough, Massachusetts
| | - Steve Reinitz
- Boston Scientific Corporation, Marlborough, Massachusetts
| | | | - Kristine Roy
- Boston Scientific Corporation, Marlborough, Massachusetts
| | | | - Alison Osattin
- Boston Scientific Corporation, Marlborough, Massachusetts
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14
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The Role of Oxidative Stress in Physiopathology and Pharmacological Treatment with Pro- and Antioxidant Properties in Chronic Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:2082145. [PMID: 32774665 PMCID: PMC7396016 DOI: 10.1155/2020/2082145] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/08/2020] [Indexed: 01/01/2023]
Abstract
Oxidative stress (OS) has the ability to damage different molecules and cellular structures, altering the correct function of organs and systems. OS accumulates in the body by endogenous and exogenous mechanisms. Increasing evidence points to the involvement of OS in the physiopathology of various chronic diseases that require prolonged periods of pharmacological treatment. Long-term treatments may contribute to changes in systemic OS. In this review, we discuss the involvement of OS in the pathological mechanisms of some chronic diseases, the pro- or antioxidant effects of their pharmacological treatments, and possible adjuvant antioxidant alternatives. Diseases such as high blood pressure, arteriosclerosis, and diabetes mellitus contribute to the increased risk of cardiovascular disease. Antihypertensive, lipid-lowering, and hypoglycemic treatments help reduce the risk with an additional antioxidant benefit. Treatment with methotrexate in autoimmune systemic inflammatory diseases, such as rheumatoid arthritis, has a dual role in stimulating the production of OS and producing mitochondrial dysfunction. However, it can also help indirectly decrease the systemic OS induced by inflammation. Medicaments used to treat neurodegenerative diseases tend to decrease the mechanisms related to the production of reactive oxygen species (ROS) and balance OS. On the other hand, immunosuppressive treatments used in cancer or human immunodeficiency virus infection increase the production of ROS, causing significant oxidative damage in different organs and systems without widely documented exogenous antioxidant administration alternatives.
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15
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Low Plasma Appearance of (+)-Catechin and (-)-Catechin Compared with Epicatechin after Consumption of Beverages Prepared from Nonalkalized or Alkalized Cocoa-A Randomized, Double-Blind Trial. Nutrients 2020; 12:nu12010231. [PMID: 31963163 PMCID: PMC7020035 DOI: 10.3390/nu12010231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 01/16/2023] Open
Abstract
Flavan-3-ols are claimed to be responsible for the cardioprotective effects of cocoa. Alkalized cocoa powder (ALC), commonly used for many non-confectionary products, including beverages, provides less (+)-catechin, (−)-epicatechin, and procyanidins and more (−)-catechin than nonalkalized cocoa powder (NALC). This may affect the plasma appearance of monomeric flavan-3-ol stereoisomers after consumption of NALC vs. ALC. Within a randomized, crossover trial, 12 healthy nonsmokers ingested a milk-based cocoa beverage providing either NALC or ALC. Blood was collected before and within 6 h postconsumption. (+)-Catechin, (−)-catechin, and epicatechin were analyzed in plasma by HPLC as sum of free and glucuronidated metabolites. Pharmacokinetic parameters were obtained by a one-compartment model with nonlinear regression methods. For epicatechin in plasma, total area under the curve within 6 h postconsumption (AUC0–6h) and incremental AUC0–6h were additionally calculated by using the linear trapezoidal method. After consumption of NALC and ALC, (+)-catechin and (−)-catechin were mostly not detectable in plasma, in contrast to epicatechin. For epicatechin, total AUC0–6h was different between both treatments, but not incremental AUC0–6h. Most kinetic parameters were similar for both treatments, but they varied strongly between individuals. Thus, epicatechin is the main monomeric flavan-3-ol in plasma after cocoa consumption. Whether NALC should be preferred against ALC due to its higher (−)-epicatechin content remains unclear with regard to the results on incremental AUC0–6h. Future studies should investigate epicatechin metabolites in plasma for a period up to 24 h in a larger sample size, taking into account genetic polymorphisms in epicatechin metabolism and should consider all metabolites to understand inter-individual differences after cocoa intake.
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Lapuente M, Estruch R, Shahbaz M, Casas R. Relation of Fruits and Vegetables with Major Cardiometabolic Risk Factors, Markers of Oxidation, and Inflammation. Nutrients 2019; 11:E2381. [PMID: 31590420 PMCID: PMC6835769 DOI: 10.3390/nu11102381] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 12/15/2022] Open
Abstract
Noncommunicable diseases (NCDs) are considered to be the leading cause of death worldwide. Inadequate fruit and vegetable intake have been recognized as a risk factor for almost all NCDs (type 2 diabetes mellitus, cancer, and cardiovascular and neurodegenerative diseases). The main aim of this review is to examine the possible protective effect that fruit and vegetable consumption or their bioactive compounds may have on the development of NCDs such as atherosclerosis. The accumulated evidence on the protective effects of adequate consumption of fruits and vegetables in some cases, or the lack of evidence in others, are summarized in the present review. The main conclusion of this review is that well-designed, large-scale, long-term studies are needed to truly understand the role fruit and vegetable consumption or their bioactive compounds have in atherosclerosis.
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Affiliation(s)
- Maria Lapuente
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, Barcelona 08036, Spain.
| | - Ramon Estruch
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, Barcelona 08036, Spain.
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Mana Shahbaz
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, Barcelona 08036, Spain.
| | - Rosa Casas
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, Barcelona 08036, Spain.
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid 28029, Spain.
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17
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Maaliki D, Shaito AA, Pintus G, El-Yazbi A, Eid AH. Flavonoids in hypertension: a brief review of the underlying mechanisms. Curr Opin Pharmacol 2019; 45:57-65. [DOI: 10.1016/j.coph.2019.04.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/12/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022]
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18
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Cicero AFG, Grassi D, Tocci G, Galletti F, Borghi C, Ferri C. Nutrients and Nutraceuticals for the Management of High Normal Blood Pressure: An Evidence-Based Consensus Document. High Blood Press Cardiovasc Prev 2019; 26:9-25. [DOI: 10.1007/s40292-018-0296-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 12/18/2018] [Indexed: 12/28/2022] Open
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Sánchez M, Romero M, Gómez-Guzmán M, Tamargo J, Pérez-Vizcaino F, Duarte J. Cardiovascular Effects of Flavonoids. Curr Med Chem 2019; 26:6991-7034. [DOI: 10.2174/0929867326666181220094721] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
:
Cardiovascular Disease (CVD) is the major cause of death worldwide, especially in Western
society. Flavonoids are a large group of polyphenolic compounds widely distributed in plants, present
in a considerable amount in fruit and vegetable. Several epidemiological studies found an inverse association
between flavonoids intake and mortality by CVD. The antioxidant effect of flavonoids was
considered the main mechanism of action of flavonoids and other polyphenols. In recent years, the role
of modulation of signaling pathways by direct interaction of flavonoids with multiple protein targets,
namely kinases, has been increasingly recognized and involved in their cardiovascular protective effect.
There are strong evidence, in in vitro and animal experimental models, that some flavonoids induce
vasodilator effects, improve endothelial dysfunction and insulin resistance, exert platelet antiaggregant
and atheroprotective effects, and reduce blood pressure. Despite interacting with multiple targets, flavonoids
are surprisingly safe. This article reviews the recent evidence about cardiovascular effects that
support a beneficial role of flavonoids on CVD and the potential molecular targets involved.
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Affiliation(s)
- Manuel Sánchez
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Miguel Romero
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Manuel Gómez-Guzmán
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Juan Tamargo
- Department of Pharmacology, School of Medicine, Complutense University of Madrid and Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Francisco Pérez-Vizcaino
- Department of Pharmacology, School of Medicine, Complutense University of Madrid and Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Juan Duarte
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
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20
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Santos HO, Macedo RC. Cocoa-induced (Theobroma cacao) effects on cardiovascular system: HDL modulation pathways. Clin Nutr ESPEN 2018; 27:10-15. [DOI: 10.1016/j.clnesp.2018.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/10/2018] [Indexed: 02/05/2023]
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21
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Corlin L, Ball S, Woodin M, Patton AP, Lane K, Durant JL, Brugge D. Relationship of Time-Activity-Adjusted Particle Number Concentration with Blood Pressure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092036. [PMID: 30231494 PMCID: PMC6165221 DOI: 10.3390/ijerph15092036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/08/2018] [Accepted: 09/13/2018] [Indexed: 11/24/2022]
Abstract
Emerging evidence suggests long-term exposure to ultrafine particulate matter (UFP, aerodynamic diameter < 0.1 µm) is associated with adverse cardiovascular outcomes. We investigated whether annual average UFP exposure was associated with measured systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and hypertension prevalence among 409 adults participating in the cross-sectional Community Assessment of Freeway Exposure and Health (CAFEH) study. We used measurements of particle number concentration (PNC, a proxy for UFP) obtained from mobile monitoring campaigns in three near-highway and three urban background areas in and near Boston, Massachusetts to develop PNC regression models (20-m spatial and hourly temporal resolution). Individual modeled estimates were adjusted for time spent in different micro-environments (time-activity-adjusted PNC, TAA-PNC). Mean TAA-PNC was 22,000 particles/cm3 (sd = 6500). In linear models (logistic for hypertension) adjusted for the minimally sufficient set of covariates indicated by a directed acyclic graph (DAG), we found positive, non-significant associations between natural log-transformed TAA-PNC and SBP (β = 5.23, 95%CI: −0.68, 11.14 mmHg), PP (β = 4.27, 95%CI: −0.79, 9.32 mmHg), and hypertension (OR = 1.81, 95%CI: 0.94, 3.48), but not DBP (β = 0.96, 95%CI: −2.08, 4.00 mmHg). Associations were stronger among non-Hispanic white participants and among diabetics in analyses stratified by race/ethnicity and, separately, by health status.
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Affiliation(s)
- Laura Corlin
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, 200 College Ave, Medford, MA 02155, USA.
- Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, 801 Massachusetts Avenue, Suite 470, Boston, MA 02118, USA.
| | - Shannon Ball
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, 200 College Ave, Medford, MA 02155, USA.
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
| | - Mark Woodin
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, 200 College Ave, Medford, MA 02155, USA.
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
| | - Allison P Patton
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, 200 College Ave, Medford, MA 02155, USA.
- Health Effects Institute, 75 Federal Street, Suite 1400, Boston, MA 02110, USA.
| | - Kevin Lane
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, USA.
| | - John L Durant
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, 200 College Ave, Medford, MA 02155, USA.
| | - Doug Brugge
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, 200 College Ave, Medford, MA 02155, USA.
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
- Tufts University Jonathan M. Tisch College of Civic Life, 35 Professors Row, Medford, MA 02155, USA.
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Raman G, Shams-White M, Avendano EE, Chen F, Novotny JA, Cassidy A. Dietary intakes of flavan-3-ols and cardiovascular health: a field synopsis using evidence mapping of randomized trials and prospective cohort studies. Syst Rev 2018; 7:100. [PMID: 30021626 PMCID: PMC6052707 DOI: 10.1186/s13643-018-0764-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/26/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is considerable interest in the impact of increased flavan-3-ol intake on cardiovascular disease (CVD) and diabetes outcomes. Through evidence mapping, we determined the extent of the evidence base to initiate a future systematic review investigating the impact of flavan-3-ol intake on CVD and diabetes outcomes. METHODS We developed a research protocol, convened a technical expert panel (TEP) to refine the specific research questions, conducted a systematic search in multiple databases, double-screened abstracts and full-text articles, performed data extractions, and synthesized the data. We focused on randomized controlled trials (RCTs) and prospective cohort studies which assessed intakes of flavan-3-ol from foods, beverages, and supplement/extract sources on biomarkers and clinical outcomes of CVD and diabetes. RESULTS Of 257 eligible articles, 223 and 34 publications contributed to 226 RCTs and 39 prospective cohort studies, respectively. In RCTs, the most frequently studied interventions were cocoa-based products (23.2%); berries (16.1%); tea in the form of green tea (13.9%), black tea (7.2%), or unspecified tea (3.6%); and red wine (11.2%). Mean total flavan-3-ol intake was highest in the cocoa-based trials (618.7 mg/day) and lowest in the interventions feeding red wine (123.7 mg/day). The most frequently reported outcomes were intermediate biomarkers including serum lipid levels (63.4%), blood glucose (50.9%), blood pressure (50.8%), flow-mediated dilation (21.9%), and high-sensitivity C-reactive protein (21.9%). The included 34 prospective cohort studies predominantly examined exposures to flavan-3-ols (26%), cocoa-based products (23.2%), berries (16.1%), and green tea (13.9%) and CVD incidence and mortality. CONCLUSION Through a systematic, evidence-based approach, evidence mapping on flavan-3-ol intake and CVD outcomes demonstrated sufficient data relating to flavan-3ol intake and biomarkers and clinical outcomes of CVD and diabetes. The current evidence base highlights the distribution of available data which both support the development of a future systematic review and identified the research need for future long-term RCTs. SYSTEMATIC REVIEW REGISTRATION At present, evidence mapping is not eligible for registration on the international prospective register of systematic reviews (i.e., PROSPERO).
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Affiliation(s)
- Gowri Raman
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Box 63, 800 Washington Street, Boston, MA, 02111, USA.
| | - Marissa Shams-White
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Box 63, 800 Washington Street, Boston, MA, 02111, USA.,Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Esther E Avendano
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Box 63, 800 Washington Street, Boston, MA, 02111, USA
| | - Fan Chen
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Box 63, 800 Washington Street, Boston, MA, 02111, USA.,Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Janet A Novotny
- Agricultural Research Service, U.S. Department of Agriculture, Beltsville Human Nutrition Research Center, Beltsville, MD, USA
| | - Aedin Cassidy
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
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Ottaviani JI, Heiss C, Spencer JP, Kelm M, Schroeter H. Recommending flavanols and procyanidins for cardiovascular health: Revisited. Mol Aspects Med 2018; 61:63-75. [DOI: 10.1016/j.mam.2018.02.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/31/2018] [Accepted: 02/06/2018] [Indexed: 12/26/2022]
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Intake of cocoa products and risk of type-2 diabetes: the multiethnic cohort. Eur J Clin Nutr 2018; 73:671-678. [PMID: 29795238 DOI: 10.1038/s41430-018-0188-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/30/2018] [Accepted: 03/11/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND/OBJECTIVES As cocoa products may be protective against chronic disease due to their polyphenol content, the current study determined the association of chocolate consumption and flavanol intake with type-2 diabetes (T2D) incidence in the Multiethnic Cohort (MEC) Study. SUBJECTS/METHODS The analysis included 151,691 participants of Native Hawaiian, Japanese American, Latino, African American, and white ancestry with 8487 incident T2D cases after 7.8 ± 3.5 years of follow-up. T2D status was based on three self-reports and confirmed by at least one of three administrative data sources. Dietary intake was assessed using a validated quantitative food frequency questionnaire, and flavanols from cocoa products were estimated from self-reported consumption of chocolate candy and drinks. Cox hazard regression, adjusted for potential confounders was applied to estimate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS For chocolate candy, both the highest vs. lowest (≥10 vs. <1 g/day) consumption (HR = 0.90; 95% CI, 0.83-0.97; ptrend = 0.01) and the frequency (≥4/week vs. <1/month) of intake (HR = 0.81; 95% CI, 0.72-0.91; ptrend = 0.0002) were inversely associated with T2D. The estimated flavanol intake from cocoa products (≥3 vs. <1 mg/day) also showed an inverse association with T2D risk (HR = 0.93; 95% CI, 0.88-0.99; ptrend = 0.02). Significant interaction terms indicated that the inverse relation was limited to Japanese Americans, normal-weight individuals, and to those without comorbidities. CONCLUSIONS The current study confirms previous reports that participants with high intake of chocolate products and cocoa-derived flavanols experience a reduced risk of developing T2D even after controlling for sugar intake, diet quality, and other aspects of the diet.
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Kord-Varkaneh H, Ghaedi E, Nazary-Vanani A, Mohammadi H, Shab-Bidar S. Does cocoa/dark chocolate supplementation have favorable effect on body weight, body mass index and waist circumference? A systematic review, meta-analysis and dose-response of randomized clinical trials. Crit Rev Food Sci Nutr 2018; 59:2349-2362. [PMID: 29553824 DOI: 10.1080/10408398.2018.1451820] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Cocoa and dark chocolate (DC) have been reported to be effective for health promotion; however the exact effect of cocoa/DC on anthropometric measures have not been yet defined. Methods: A comprehensive search to identify randomized clinical trials investigating the impact of cocoa/DC on body weight, body mass index (BMI) and waist circumference (WC) was performed up to December 2017. A meta-analysis of eligible studies was performed using random effects model to estimate pooled effect size. Fractional polynominal modeling was used to explore dose-response relationships. Results: A total of 35 RCTs investigated the effects of cocoa/DC on weight, BMI and WC were included. Meta-analysis did not suggest any significant effect of cocoa/DC supplementation on body weight (-0.108 kg, 95% CI -0.262, 0.046 P = 0.168), BMI (-0.014 kg/m2 95% CI -0.105, 0.077, P: 0.759,) and WC (0.025 cm 95% CI -0.083, 0.129, P = 0.640). Subgroup analysis revealed that that weight and BMI were reduced with cocoa/DC supplementation ≥ 30 g chocolate per day in trials between 4-8 weeks. Cocoa/DC consumption resulted in WC reduction in non-linear fashion (r = 0.042, P-nonlinearity = 0.008).Conclusion: Cocoa/DC supplementation does not reduce anthropometric measures significantly. However subgroup analysis regarding dose (≥ 30 g/day) and duration (between 4 to 8 weeks) revealed significant reduction of body weight and BMI.
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Affiliation(s)
- Hamed Kord-Varkaneh
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran.,b Department of Cellular and molecular Nutrition, School of Nutritional sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
| | - Ehsan Ghaedi
- b Department of Cellular and molecular Nutrition, School of Nutritional sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
| | - Ali Nazary-Vanani
- b Department of Cellular and molecular Nutrition, School of Nutritional sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
| | - Hamed Mohammadi
- c Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences , Isfahan , Iran.,d Students' Research Committee, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Sakineh Shab-Bidar
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
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Lee Y, Berryman CE, West SG, Chen CYO, Blumberg JB, Lapsley KG, Preston AG, Fleming JA, Kris-Etherton PM. Effects of Dark Chocolate and Almonds on Cardiovascular Risk Factors in Overweight and Obese Individuals: A Randomized Controlled-Feeding Trial. J Am Heart Assoc 2017; 6:e005162. [PMID: 29187388 PMCID: PMC5778992 DOI: 10.1161/jaha.116.005162] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 10/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Consumption of almonds or dark chocolate and cocoa has favorable effects on markers of coronary heart disease; however, the combined effects have not been evaluated in a well-controlled feeding study. The aim of this study was to examine the individual and combined effects of consumption of dark chocolate and cocoa and almonds on markers of coronary heart disease risk. METHODS AND RESULTS A randomized controlled, 4-period, crossover, feeding trial was conducted in overweight and obese individuals aged 30 to 70 years. Forty-eight participants were randomized, and 31 participants completed the entire study. Each diet period was 4 weeks long, followed by a 2-week compliance break. Participants consumed each of 4 isocaloric, weight maintenance diets: (1) no treatment foods (average American diet), (2) 42.5 g/d of almonds (almond diet [ALD]), (3) 18 g/d of cocoa powder and 43 g/d of dark chocolate (chocolate diet [CHOC]), or (4) all 3 foods (CHOC+ALD). Compared with the average American diet, total cholesterol, non-high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after the ALD were lower by 4%, 5%, and 7%, respectively (P<0.05). The CHOC+ALD decreased apolipoprotein B by 5% compared with the average American diet. For low-density lipoprotein subclasses, compared with the average American diet, the ALD showed a greater reduction in large buoyant low-density lipoprotein particles (-5.7±2.3 versus -0.3±2.3 mg/dL; P=0.04), whereas the CHOC+ALD had a greater decrease in small dense low-density lipoprotein particles (-12.0±2.8 versus -5.3±2.8 mg/dL; P=0.04). There were no significant differences between diets for measures of vascular health and oxidative stress. CONCLUSIONS Our results demonstrate that consumption of almonds alone or combined with dark chocolate under controlled-feeding conditions improves lipid profiles. Incorporating almonds, dark chocolate, and cocoa into a typical American diet without exceeding energy needs may reduce the risk of coronary heart disease. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01882881.
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Affiliation(s)
- Yujin Lee
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Claire E Berryman
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Sheila G West
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - C-Y Oliver Chen
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Jeffrey B Blumberg
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | | | | | - Jennifer A Fleming
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
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Polyphenols and Oxidative Stress in Atherosclerosis-Related Ischemic Heart Disease and Stroke. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:8526438. [PMID: 29317985 PMCID: PMC5727797 DOI: 10.1155/2017/8526438] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/16/2017] [Accepted: 10/18/2017] [Indexed: 12/15/2022]
Abstract
Good nutrition could maintain health and life. Polyphenols are common nutrient mainly derived from fruits, vegetables, tea, coffee, cocoa, mushrooms, beverages, and traditional medicinal herbs. They are potential substances against oxidative-related diseases, for example, cardiovascular disease, specifically, atherosclerosis-related ischemic heart disease and stroke, which are health and economic problems recognized worldwide. In this study, we reviewed the risk factors for atherosclerosis, including hypertension, diabetes mellitus, hyperlipidemia, obesity, and cigarette smoking as well as the antioxidative activity of polyphenols, which could prevent the pathology of atherosclerosis, including endothelial dysfunction, low-density lipoprotein oxidation, vascular smooth muscle cell proliferation, inflammatory process by monocytes, macrophages or T lymphocytes, and platelet aggregation. The strong radical-scavenging properties of polyphenols would exhibit antioxidative and anti-inflammation effects. Polyphenols reduce ROS production by inhibiting oxidases, reducing the production of superoxide, inhibiting OxLDL formation, suppressing VSMC proliferation and migration, reducing platelet aggregation, and improving mitochondrial oxidative stress. Polyphenol consumption also inhibits the development of hypertension, diabetes mellitus, hyperlipidemia, and obesity. Despite the numerous in vivo and in vitro studies, more advanced clinical trials are necessary to confirm the efficacy of polyphenols in the treatment of atherosclerosis-related vascular diseases.
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Petyaev IM, Bashmakov YK. Dark Chocolate: Opportunity for an Alliance between Medical Science and the Food Industry? Front Nutr 2017; 4:43. [PMID: 29034240 PMCID: PMC5626948 DOI: 10.3389/fnut.2017.00043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/06/2017] [Indexed: 01/07/2023] Open
Abstract
Dark chocolate (DC) was originally introduced in human nutrition as a medicinal product consumable in a liquid form. Century-long efforts of food industry transformed this hardly appealing product into a valuable modern culinary delight with clear predominance of confectionery brands of DC on the market. However, current epidemiological data as well as multiple experimental and clinical observations reveal that DC consumption may have a profound effect on cardiovascular, central nervous systems, hemostasis, and lipid metabolism. However, despite of growing body of modern scientific evidence revealing medicinal properties of cocoa-based products, DC remains more gourmet culinary item than medicinal food product. Even today there are no clear dietary recommendations on consumption of cocoa flavonoids (flavanols) for health purpose. Clinical trials with DC rarely include monitoring of plasma flavanol concentration in volunteers. Moreover, there is no standardized assay or any quantitative requirements for flavanol content in the commercial brands of DC. High flavanol content is often sacrificed during manufacturing for a better taste of DC due to bitterness of cocoa flavonoids. All these problems including subsequently arising ethical issues need to be addressed by joint efforts of food industry and medical science. Moreover, application of microencapsulation technology in DC manufacturing, as well as molecular selection of best flavanol producers may drastically change bioavailability of DC bioactive ingredients and DC production technology. Nevertheless, only strict causative approach, linking possible health effect of DC to its bioactive ingredients considered as nutraceuticals, may change the current landscape in nutritional research related to cocoa-based products and create a trustworthy path for their medicinal use.
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Liu AG, Ford NA, Hu FB, Zelman KM, Mozaffarian D, Kris-Etherton PM. A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion. Nutr J 2017; 16:53. [PMID: 28854932 PMCID: PMC5577766 DOI: 10.1186/s12937-017-0271-4] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 08/15/2017] [Indexed: 12/11/2022] Open
Abstract
Consumers are often confused about nutrition research findings and recommendations. As content experts, it is essential that nutrition scientists communicate effectively. A case-study of the history of dietary fat science and recommendations is presented, summarizing presentations from an Experimental Biology Symposium that addressed techniques for effective scientific communication and used the scientific discourse of public understanding of dietary fats and health as an example of challenges in scientific communication. Decades of dietary recommendations have focused on balancing calorie intake and energy expenditure and decreasing fat. Reducing saturated fat has been a cornerstone of dietary recommendations for cardiovascular disease (CVD) risk reduction. However, evidence from observational studies and randomized clinical trials demonstrates that replacing saturated fat with carbohydrates, specifically refined, has no benefit on CVD risk, while substituting polyunsaturated fats for either saturated fat or carbohydrate reduces risk. A significant body of research supports the unique health benefits of dietary patterns and foods that contain plant and marine sources of unsaturated fats. Yet, after decades of focus on low-fat diets, many consumers, food manufacturers, and restauranteurs remain confused about the role of dietary fats on disease risk and sources of healthy fats. Shifting dietary recommendations to focus on food-based dietary patterns would facilitate translation to the public and potentially remedy widespread misperceptions about what constitutes a healthful dietary pattern.
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Affiliation(s)
- Ann G. Liu
- Freelance Medical Writer, West Lafayette, IN USA
| | - Nikki A. Ford
- Director of Nutrition, Avocado Nutrition Center, Mission Viejo, CA USA
| | - Frank B. Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | | | | | - Penny M. Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, PA USA
- 319 Chandlee Laboratory, Pennsylvania State University, University Park, Pennsylvania, PA 16802 USA
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Peltzer K, Pengpid S, Sychareun V, Ferrer AJG, Low WY, Huu TN, Win HH, Rochmawati E, Turnbull N. Prehypertension and psychosocial risk factors among university students in ASEAN countries. BMC Cardiovasc Disord 2017; 17:230. [PMID: 28835205 PMCID: PMC5569482 DOI: 10.1186/s12872-017-0666-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/16/2017] [Indexed: 01/13/2023] Open
Abstract
Background Existing evidence suggests that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal. The aim of this study was to evaluate the prevalence of prehypertension, hypertension and to identify psychosocial risk factors for prehypertension among university students in Association of South East Asian Nation (ASEAN) countries. Methods Based on a cross-sectional survey, the total sample included 4649 undergraduate university students (females = 65.3%; mean age 20.5, SD = 2.9, age range of 18–30 years) from 7 ASEAN countries (Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand and Vietnam). Blood pressure, anthropometric, health behaviour and psychosocial variables were measured. Results Overall, 19.0% of the undergraduate university students across ASEAN countries had prehypertension, 6.7% hypertension and 74.2% were normotensives. There was country variation in prehypertension prevalence, ranging from 11.3% in Indonesia and 11.5% in Malaysia to above 18% in Laos, Myanmar and Thailand. In multivariate analysis, sociodemographic variables (male gender, living in an upper middle income country, and living on campus or off campus on their own), nutrition and weight variables (not being underweight and obese, having once or more times soft drinks in a day and never or rarely having chocolate or candy), heavy drinking and having depressive symptoms were associated with prehypertension. Conclusion The study found a high prevalence of prehypertension in ASEAN university students. Several psychosocial risk factors including male gender, obesity, soft drinks consumption, heavy drinking and depression symptoms have been identified which can help in intervention programmes.
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Affiliation(s)
- Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam. .,Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
| | - Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.,Department of Research & Innovation, University of Limpopo, Polokwane, South Africa
| | - Vanphanom Sychareun
- Faculty of Postgraduate Studies, University of Health Sciences, Ministry of Health Vientiane, Vientiane, Lao PDR
| | - Alice Joan G Ferrer
- Division of Social Sciences, University of the Philippines Visayas, Miagao, 5023, Iloilo, Philippines
| | - Wah Yun Low
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Thang Nguyen Huu
- Faculty of Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hla Hla Win
- Preventive and Social Medicine Department, University of Medicine 1, Yangon, Myanmar
| | - Erna Rochmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Jl. Lingkar Selatan, Tamantirto, Kasihan, Bantul, DI Yogyakarta, Yogyakarta, Indonesia
| | - Niruwan Turnbull
- Faculty of Public Health, Mahasarakham University, Maha Sarakham, Thailand
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Ludovici V, Barthelmes J, Nägele MP, Enseleit F, Ferri C, Flammer AJ, Ruschitzka F, Sudano I. Cocoa, Blood Pressure, and Vascular Function. Front Nutr 2017; 4:36. [PMID: 28824916 PMCID: PMC5539137 DOI: 10.3389/fnut.2017.00036] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/10/2017] [Indexed: 02/05/2023] Open
Abstract
Cardiovascular disease (CVD) represents the most common cause of death worldwide. The consumption of natural polyphenol-rich foods, and cocoa in particular, has been related to a reduced risk of CVD, including coronary heart disease and stroke. Intervention studies strongly suggest that cocoa exerts a beneficial impact on cardiovascular health, through the reduction of blood pressure (BP), improvement of vascular function, modulation of lipid and glucose metabolism, and reduction of platelet aggregation. These potentially beneficial effects have been shown in healthy subjects as well as in patients with risk factors (arterial hypertension, diabetes, and smoking) or established CVD (coronary heart disease or heart failure). Several potential mechanisms are supposed to be responsible for the positive effect of cocoa; among them activation of nitric oxide (NO) synthase, increased bioavailability of NO as well as antioxidant, and anti-inflammatory properties. It is the aim of this review to summarize the findings of cocoa and chocolate on BP and vascular function.
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Affiliation(s)
- Valeria Ludovici
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland.,Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Jens Barthelmes
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Matthias P Nägele
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Frank Enseleit
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andreas J Flammer
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Frank Ruschitzka
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Isabella Sudano
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland
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Heiss C, Spyridopoulos I, Haendeler J. Interventions to slow cardiovascular aging: Dietary restriction, drugs and novel molecules. Exp Gerontol 2017; 109:108-118. [PMID: 28658611 DOI: 10.1016/j.exger.2017.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 06/16/2017] [Accepted: 06/21/2017] [Indexed: 02/05/2023]
Abstract
Cardiovascular aging is a highly dynamic process. Despite the fact that cardiovascular function and structure change with age, they can still be modulated even in aged humans. The most prominent approaches to improve age-dependent vascular changes include dietary restriction and pharmacologic agents interacting with signaling pathways implicated in this context. These include inhibition of TOR, glycolysis, and GH/IGF-1, activation of sirtuins, and AMPK, as well as modulators of inflammation, epigenetic pathways, and telomeres. Promising nutritional approaches include Mediterranean diet and novel dietary bioactives including flavanols, anthocyanins, and lignins. Many plant bioactives improve cardiovascular parameters implied in vascular healthy aging including endothelial function, arterial stiffness, blood pressure, cholesterol, and glycemic control. However, the mechanism of action of most bioactives is not established and it remains to be elucidated whether they act as dietary restriction mimetics or via other modes of action. Even more importantly, whether these interventions can slow or even reverses components of cardiovascular aging itself and can increase healthspan or longevity in humans needs to be determined.
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Affiliation(s)
- Christian Heiss
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany.
| | - Ioakim Spyridopoulos
- Institute of Genetic Medicine, Medical Faculty, Newcastle University, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK.
| | - Judith Haendeler
- Central Institute of Clinical Chemistry and Laboratory Medicine, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany; IUF-Leibniz Research Institute for Environmental Medicine, Auf'm Hennekamp 50, 40225 Duesseldorf, Germany.
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Abstract
BACKGROUND High blood pressure is an important risk factor for cardiovascular disease, contributing to about 50% of cardiovascular events worldwide and 37% of cardiovascular-related deaths in Western populations. Epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. Flavanols found in cocoa have been shown to increase the formation of endothelial nitric oxide which promotes vasodilation and therefore blood pressure reduction. Here we update previous meta-analyses on the effect of cocoa on blood pressure. OBJECTIVES To assess the effects on blood pressure of chocolate or cocoa products versus low-flavanol products or placebo in adults with or without hypertension when consumed for two weeks or longer. SEARCH METHODS This is an updated version of the review initially published in 2012. In this updated version, we searched the following electronic databases from inception to November 2016: Cochrane Hypertension Group Specialised Register, CENTRAL, MEDLINE and Embase. We also searched international trial registries, and the reference lists of review articles and included trials. SELECTION CRITERIA Randomised controlled trials (RCTs) investigating the effects of chocolate or cocoa products on systolic and diastolic blood pressure in adults for a minimum of two weeks duration. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias in each trial. We conducted random-effects meta-analyses on the included studies using Review Manager 5. We explored heterogeneity with subgroup analyses by baseline blood pressure, flavanol content of control group, blinding, age and duration. Sensitivity analyses explored the influence of unusual study design. MAIN RESULTS Thirty-five trials (including 40 treatment comparisons) met the inclusion criteria. Of these, we added 17 trials (20 treatment comparisons) to the 18 trials (20 treatment comparisons) in the previous version of this updated review.Trials provided participants with 30 to 1218 mg of flavanols (mean = 670 mg) in 1.4 to 105 grams of cocoa products per day in the active intervention group. The control group received either a flavanol-free product (n = 26 treatment comparisons) or a low-flavanol-containing cocoa powder (range 6.4 to 88 mg flavanols (mean = 55 mg, 13 treatment comparisons; 259 mg, 1 trial).Meta-analyses of the 40 treatment comparisons involving 1804 mainly healthy participants revealed a small but statistically significant blood pressure-reducing effect of flavanol-rich cocoa products compared with control in trials of two to 18 weeks duration (mean nine weeks):Mean difference systolic blood pressure (SBP) (95% confidence interval (CI): -1.76 (-3.09 to -0.43) mmHg, P = 0.009, n = 40 treatment comparisons, 1804 participants;Mean difference diastolic blood pressure (DBP) (95% CI): -1.76 (-2.57 to -0.94) mmHg, P < 0.001, n = 39 treatment comparisons, 1772 participants.Baseline blood pressure may play a role in the effect of cocoa on blood pressure. While systolic blood pressure was reduced significantly by 4 mmHg in hypertensive people (n = 9 treatment comparisons, 401 participants), and tended to be lowered in prehypertensive people (n= 8 treatment comparisons, 340 participants), there was no significant difference in normotensive people (n = 23 treatment comparisons, 1063 participants); however, the test for subgroup differences was of borderline significance (P = 0.08; I2 = 60%), requiring further research to confirm the findings.Subgroup meta-analysis by blinding suggested a trend towards greater blood pressure reduction in unblinded trials compared to double-blinded trials, albeit statistically not significant. Further research is needed to confirm whether participant expectation may influence blood pressure results. Subgroup analysis by type of control (flavanol-free versus low-flavanol control) did not reveal a significant difference.Whether the age of participants plays a role in the effect of cocoa on blood pressure, with younger participants responding with greater blood pressure reduction, needs to be further investigated.Sensitivity analysis excluding trials with authors employed by trials sponsoring industry (33 trials, 1482 participants) revealed a small reduction in effect size, indicating some reporting bias.Due to the remaining heterogeneity, which we could not explain in terms of blinding, flavanol content of the control groups, age of participants, or study duration, we downgraded the quality of the evidence from high to moderate.Results of subgroup analyses should be interpreted with caution and need to be confirmed or refuted in trials using direct randomised comparisons.Generally, cocoa products were highly tolerable, with adverse effects including gastrointestinal complaints and nausea being reported by 1% of participants in the active cocoa intervention group and 0.4% of participants in the control groups (moderate-quality evidence). AUTHORS' CONCLUSIONS This review provides moderate-quality evidence that flavanol-rich chocolate and cocoa products cause a small (2 mmHg) blood pressure-lowering effect in mainly healthy adults in the short term.These findings are limited by the heterogeneity between trials, which could not be explained by prespecified subgroup analyses, including blinding, flavanol content of the control groups, age of participants, or study duration. However, baseline blood pressure may play a role in the effect of cocoa on blood pressure; subgroup analysis of trials with (pre)hypertensive participants revealed a greater blood pressure-reducing effect of cocoa compared to normotensive participants with borderline significance.Long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events and to assess potential adverse effects associated with chronic ingestion of cocoa products.
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Affiliation(s)
- Karin Ried
- National Institute of Integrative Medicine21 Burwood RdHawthornMelbourneVictoriaAustralia3122
- The University of AdelaideDiscipline of General PracticeAdelaideSouth AustraliaAustralia5005
| | - Peter Fakler
- The University of AdelaideDiscipline of General PracticeAdelaideSouth AustraliaAustralia5005
| | - Nigel P Stocks
- The University of AdelaideDiscipline of General PracticeAdelaideSouth AustraliaAustralia5005
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Chocolate Consumption and Risk of Heart Failure: A Meta-Analysis of Prospective Studies. Nutrients 2017; 9:nu9040402. [PMID: 28425931 PMCID: PMC5409741 DOI: 10.3390/nu9040402] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/14/2017] [Accepted: 04/17/2017] [Indexed: 12/18/2022] Open
Abstract
Epidemiological studies have shown inconsistent findings on the association between chocolate consumption and risk of heart failure (HF). We, therefore, performed a meta-analysis of prospective studies to determine the role of chocolate intake in the prevention of HF. We searched databases of PubMed, Web of Science, and Scopus through December 2016 and scrutinized the reference lists of relevant literatures to identify eligible studies. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were aggregated using random effect models. The dose–response relationship between chocolate consumption and incident HF was also assessed. This meta-analysis is registered with PROSPERO, number CRD42017054230. Five prospective studies with 106,109 participants were finally included. Compared to no consumption of chocolate, the pooled HRs (95% CIs) of HF were 0.86 (0.82–0.91) for low-to-moderate consumption (<7 servings/week) and 0.94 (0.80–1.09) for high consumption (≥7 servings/week). In dose–response meta-analysis, we detected a curve linear relationship between chocolate consumption and risk of HF (p for nonlinearity = 0.005). Compared with non-consumption, the HRs (95% CIs) of HF across chocolate consumption levels were 0.92 (0.88–0.97), 0.86 (0.78–0.94), 0.93 (0.85–1.03), and 1.07 (0.92–1.23) for 1, 3, 7, and 10 servings/week, respectively. In conclusion, chocolate consumption in moderation may be associated with a decreased risk of HF.
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Sosnowska B, Penson P, Banach M. The role of nutraceuticals in the prevention of cardiovascular disease. Cardiovasc Diagn Ther 2017; 7:S21-S31. [PMID: 28529919 PMCID: PMC5418215 DOI: 10.21037/cdt.2017.03.20] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 02/27/2017] [Indexed: 12/21/2022]
Abstract
Cardiovascular disease (CVD) ranks among the most common health-related and economic issues worldwide. Dietary factors are important contributors to cardiovascular risk, either directly, or through their effects on other cardiovascular risk factors including hypertension, dyslipidemia and diabetes mellitus. Nutraceuticals are natural nutritional compounds, which have been shown to be efficacious in preventative medicine or in the treatment of disease. Several foods and dietary supplements have been shown to protect against the development of CVD. The aim of this review is to present an update on the most recent evidence relating to the use of nutraceuticals in the context of the prevention and treatment of CVD.
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Affiliation(s)
- Bozena Sosnowska
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
| | - Peter Penson
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
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Abstract
CVD remain the leading cause of death globally. Effective dietary strategies for their reduction are of high priority. Increasing evidence suggests that phytochemicals, particularly dietary flavonoids and nitrates, are key modulators of CVD risk reduction through impact on multiple risk factors. The aim of this review is to explore the evidence for the impact of flavonoid- and nitrate-rich foods and supplements on CVD risk, with specific reference to their importance as mediators of vascular health and platelet function. There is accumulating evidence to support benefits of dietary flavonoids on cardiovascular health. Dose-dependent recovery of endothelial function and lowering of blood pressure have been reported for the flavanol (-)-epicatechin, found in cocoa, apples and tea, through production and availability of endothelial nitric oxide (NO). Furthermore, flavonoids, including quercetin and its metabolites, reduce in vitro and ex vivo platelet function via inhibition of phosphorylation-dependent cellular signalling pathways, although further in vivo studies are required to substantiate these mechanistic effects. Hypotensive effects of dietary nitrates have been consistently reported in healthy subjects in acute and chronic settings, although there is less evidence for these effects in patient groups. Proposed mechanisms of actions include endothelial-independent NO availability, which is dependent on the entro-salivary circulation and microbial conversion of dietary nitrate to nitrite in the mouth. In conclusion, flavonoid- and nitrate-rich foods show promising effects on vascular function, yet further randomly controlled studies are required to confirm these findings and to determine effective doses.
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Affiliation(s)
- Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition,Department of Food and Nutritional Sciences,Reading RG6 6AP,UK
| | - Alex Stainer
- Institute for Cardiovascular and Metabolic Research (ICMR),University of Reading,Whiteknights,Reading RG6 6AP,UK
| | - Ditte A Hobbs
- Hugh Sinclair Unit of Human Nutrition,Department of Food and Nutritional Sciences,Reading RG6 6AP,UK
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Chocolate intake and incidence of heart failure: Findings from the Cohort of Swedish Men. Am Heart J 2017; 183:18-23. [PMID: 27979037 DOI: 10.1016/j.ahj.2016.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 10/01/2016] [Indexed: 12/16/2022]
Abstract
The objective of this study was to evaluate the association of chocolate consumption and heart failure (HF) in a large population of Swedish men. METHODS We conducted a prospective cohort study of 31,917 men 45-79 years old with no history of myocardial infarction, diabetes, or HF at baseline who were participants in the population-based Cohort of Swedish Men study. Chocolate consumption was assessed through a self-administrated food frequency questionnaire. Participants were followed for HF hospitalization or mortality from January 1, 1998, to December 31, 2011, using record linkage to the Swedish inpatient and cause-of-death registries. RESULTS During 14 years of follow-up, 2,157 men were hospitalized (n=1,901) or died from incident HF (n=256). Compared with subjects who reported no chocolate intake, the multivariable-adjusted rate ratio of HF was 0.88 (95% CI 0.78-0.99) for those consuming 1-3 servings per month, 0.83 (95% CI 0.72-0.94) for those consuming 1-2 servings per week, 0.82 (95% CI 0.68-0.99) for those consuming 3-6 servings per week, and 1.10 (95% CI 0.84-1.45) for those consuming ≥1 serving per day (P for quadratic trend=.001). CONCLUSIONS In this large prospective cohort study, there was a J-shaped relationship between chocolate consumption and HF incidence. Moderate chocolate consumption was associated with a lower rate of HF hospitalization or death, but the protective association was not observed among individuals consuming ≥1 serving per day. Journal Subject Codes: Etiology: Epidemiology, Heart failure: Congestive.
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Aprotosoaie AC, Miron A, Trifan A, Luca VS, Costache II. The Cardiovascular Effects of Cocoa Polyphenols-An Overview. Diseases 2016; 4:E39. [PMID: 28933419 PMCID: PMC5456324 DOI: 10.3390/diseases4040039] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 12/30/2022] Open
Abstract
Cocoa is a rich source of high-quality antioxidant polyphenols. They comprise mainly catechins (29%-38% of total polyphenols), anthocyanins (4% of total polyphenols) and proanthocyanidins (58%-65% of total polyphenols). A growing body of experimental and epidemiological evidence highlights that the intake of cocoa polyphenols may reduce the risk of cardiovascular events. Beyond antioxidant properties, cocoa polyphenols exert blood pressure lowering activity, antiplatelet, anti-inflammatory, metabolic and anti-atherosclerotic effects, and also improve endothelial function. This paper reviews the role of cocoa polyphenols in cardiovascular protection, with a special focus on mechanisms of action, clinical relevance and correlation between antioxidant activity and cardiovascular health.
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Affiliation(s)
- Ana Clara Aprotosoaie
- Department of Pharmacognosy, Faculty of Pharmacy, University of Medicine and Pharmacy Grigore T. Popa Iasi, Universitatii Str. 16, 700115 Iasi, Romania.
| | - Anca Miron
- Department of Pharmacognosy, Faculty of Pharmacy, University of Medicine and Pharmacy Grigore T. Popa Iasi, Universitatii Str. 16, 700115 Iasi, Romania.
| | - Adriana Trifan
- Department of Pharmacognosy, Faculty of Pharmacy, University of Medicine and Pharmacy Grigore T. Popa Iasi, Universitatii Str. 16, 700115 Iasi, Romania.
| | - Vlad Simon Luca
- Department of Pharmacognosy, Faculty of Pharmacy, University of Medicine and Pharmacy Grigore T. Popa Iasi, Universitatii Str. 16, 700115 Iasi, Romania.
| | - Irina-Iuliana Costache
- Department of Cardiology, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa Iasi, Universitatii Str. 16, 700115 Iasi, Romania.
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Lin X, Zhang I, Li A, Manson JE, Sesso HD, Wang L, Liu S. Cocoa Flavanol Intake and Biomarkers for Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr 2016; 146:2325-2333. [PMID: 27683874 PMCID: PMC5086796 DOI: 10.3945/jn.116.237644] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/29/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cocoa flavanols may improve cardiometabolic health. Evidence from small short-term randomized clinical trials (RCTs) remains inconsistent, and large long-term RCTs testing the efficacy of cocoa flavanols are still lacking. OBJECTIVE We performed a systematic review and meta-analysis of RCTs to quantify the effect of cocoa flavanol intake on cardiometabolic biomarkers. METHODS We searched PubMed, Web of Science, and the Cochrane Library for RCTs that evaluated the effects of cocoa flavanols on biomarkers relevant to vascular disease pathways among adults. Data were extracted following a standardized protocol. We used DerSimonian and Laird random-effect models to compute the weighted mean differences (WMDs) and 95% CIs. We also examined potential modification by intervention duration, design, age, sex, comorbidities, and the form and amount of cocoa flavanol intake. RESULTS We included 19 RCTs that comprised 1131 participants, and the number of studies for a specific biomarker varied. The amount of cocoa flavanols ranged from 166 to 2110 mg/d, and intervention duration ranged from 2 to 52 wk. Cocoa flavanol intake significantly improved insulin sensitivity and lipid profile. The WMDs between treatment and placebo were -0.10 mmol/L (95% CI: -0.16, -0.04 mmol/L) for total triglycerides, 0.06 mmol/L (95% CI: 0.02, 0.09 mmol/L) for HDL cholesterol, -2.33 μIU/mL (95% CI: -3.47, -1.19 μIU/mL) for fasting insulin, -0.93 (95% CI: -1.31, -0.55) for the homeostatic model assessment of insulin resistance, 0.03 (95% CI: 0.01, 0.05) for the quantitative insulin sensitivity check index, 2.54 (95% CI: 0.63, 4.44) for the insulin sensitivity index, -0.83 mg/dL (95% CI: -0.88, -0.77 mg/dL) for C-reactive protein, and 85.6 ng/mL (95% CI: 16.0, 155 ng/mL) for vascular cell adhesion molecule 1. No significant associations were found for other biomarkers. None of the modifiers seemed to qualitatively modify the effects of cocoa flavanol intake. CONCLUSIONS Our study suggests that cocoa flavanol intake has favorable effects on select cardiometabolic biomarkers among adults. These findings support the need for large long-term RCTs to assess whether cocoa flavanol intake reduces the risk of diabetes and cardiovascular events.
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Affiliation(s)
- Xiaochen Lin
- Department of Epidemiology and Center for Global Cardiometabolic Health, Brown University, Providence, RI
| | - Isabel Zhang
- Department of Epidemiology and Center for Global Cardiometabolic Health, Brown University, Providence, RI
| | - Alina Li
- Oxford College of Emory University, Oxford, GA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and
| | - Lu Wang
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Simin Liu
- Department of Epidemiology and Center for Global Cardiometabolic Health, Brown University, Providence, RI; .,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and.,Division of Endocrinology, Department of Medicine, Warren Alpert Medical School and Rhode Island Hospital, Providence, RI
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Njike VY, Hamburg N, Kellogg M, Annapureddy A, Vita J. Dose and response to cocoa (DARC): A randomized double-blind controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.ctrsc.2016.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Tomé-Carneiro J, Visioli F. Polyphenol-based nutraceuticals for the prevention and treatment of cardiovascular disease: Review of human evidence. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:1145-1174. [PMID: 26776959 DOI: 10.1016/j.phymed.2015.10.018] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND In addition to prescription drugs, nutraceuticals/functional foods/medical foods are being increasingly added as adjunct treatment of cardiovascular disease (CVD), even though most of them have been exclusively studied in vitro. HYPOTHESIS/PURPOSE We review the available evidence (focusing on when the amount of polyphenols' intake was measured) coming from randomized controlled trials (RCTs) of (poly)phenol-based supplements. CONCLUSION We conclude that (poly)phenol-based nutraceuticals and functional foods might be indeed used as adjunct therapy of CVD, but additional long-term RCTs with adequate numerosity and with clinically relevant end points are needed to provide unequivocal evidence of their clinical usefulness.
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Affiliation(s)
- Joao Tomé-Carneiro
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA) - Food, CEI UAM+CSIC, Madrid, Spain
| | - Francesco Visioli
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA) - Food, CEI UAM+CSIC, Madrid, Spain; Department of Molecular Medicine, University of Padova, Viale G. Colombo 3, 35121 Padova, Italy .
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42
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Cicero AFG, Colletti A. Role of phytochemicals in the management of metabolic syndrome. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:1134-44. [PMID: 26778479 DOI: 10.1016/j.phymed.2015.11.009] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 11/14/2015] [Accepted: 11/19/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND The World Health Organization (WHO) for some years has been focusing on what is now commonly referred to as an "epidemic of obesity and diabetes" ("diabesity"): behind this outbreak, there are several risk factors grouped in what is called "metabolic syndrome" (MetS). The basis of this "epidemic" is either a diet too often characterized by excessive consumption of saturated and trans-esterified fatty acids, simple sugars and salt, either a sedentary lifestyle. PURPOSE The aim of this review is to focus on the phytochemicals that have a more positive effect on the treatment and/or prevention of MetS. CHAPTERS Treatment strategies for MetS include pharmacologic and non-pharmacologic options, with varying degrees of success rate. The first is indicated for patients with high cardiovascular risk, while the second one is the most cost-effective preventive approach for subjects with borderline parameters and for patients intolerant to pharmacological therapy. MetS non-pharmacological treatments could involve the use of nutraceuticals, most of which has plant origins (phytochemicals), associated with lifestyle improvement. The chapter will discuss the available evidence on soluble fibres from psyllium and other sources, cinnamaldehyde, cinnamic acid and other cinnamon phytochemicals, berberine, corosolic acid from banaba, charantin from bitter gourd, catechins and flavonols from green tea and cocoa. Vegetable omega-3 polyunsaturated fatty acids, alliin from garlic, soy peptides, and curcumin from curcuma longa. CONCLUSION Some nutraceuticals, when adequately dosed, should improve a number of the MetS components.
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Affiliation(s)
- Arrigo F G Cicero
- Diseases Research Center, Medicine & Surgery Dept., Alma Mater Studiorum Atherosclerosis and Metabolic University of Bologna, Bologna, Italy.
| | - Alessandro Colletti
- Diseases Research Center, Medicine & Surgery Dept., Alma Mater Studiorum Atherosclerosis and Metabolic University of Bologna, Bologna, Italy
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Loo BM, Erlund I, Koli R, Puukka P, Hellström J, Wähälä K, Mattila P, Jula A. Consumption of chokeberry (Aronia mitschurinii) products modestly lowered blood pressure and reduced low-grade inflammation in patients with mildly elevated blood pressure. Nutr Res 2016; 36:1222-1230. [PMID: 27865620 DOI: 10.1016/j.nutres.2016.09.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/18/2016] [Accepted: 09/12/2016] [Indexed: 12/30/2022]
Abstract
Previous studies suggest that consumption of chokeberries may improve cardiovascular disease risk factor profiles. We hypothesized that chokeberries (Aronia mitschurinii) have beneficial effects on blood pressure, low-grade inflammation, serum lipids, serum glucose, and platelet aggregation in patients with untreated mild hypertension. A total of 38 participants were enrolled into a 16-week single blinded crossover trial. The participants were randomized to use cold-pressed 100% chokeberry juice (300 mL/d) and oven-dried chokeberry powder (3 g/d), or matched placebo products in random order for 8 weeks each with no washout period. The daily portion of chokeberry products was prepared from approximately 336 g of fresh chokeberries. Urinary excretion of various polyphenols and their metabolites increased during the chokeberry period, indicating good compliance. Chokeberries decreased daytime blood pressure and low-grade inflammation. The daytime ambulatory diastolic blood pressure decreased (-1.64 mm Hg, P = .02), and the true awake ambulatory systolic (-2.71 mm Hg, P = .077) and diastolic (-1.62 mm Hg, P = .057) blood pressure tended to decrease. The concentrations of interleukin (IL) 10 and tumor necrosis factor α decreased (-1.9 pg/mL [P = .008] and -0.67 pg/mL [P = .007], respectively) and tended to decrease for IL-4 and IL-5 (-4.5 pg/mL [P = .084] and -0.06 pg/mL [P = .059], respectively). No changes in serum lipids, lipoproteins, glucose, and in vitro platelet aggregation were noted with the chokeberry intervention. These findings suggest that inclusion of chokeberry products in the diet of participants with mildly elevated blood pressure has minor beneficial effects on cardiovascular health.
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Affiliation(s)
- Britt-Marie Loo
- Department of Health, National Institute for Health and Welfare, Turku, Finland; Joint Clinical Biochemistry Laboratory of University of Turku and Turku University Central Hospital, Turku, Finland
| | - Iris Erlund
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Raika Koli
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Pauli Puukka
- Department of Health, National Institute for Health and Welfare, Turku, Finland
| | - Jarkko Hellström
- Natural Resources Institute Finland, Bio-based Business and Industry, Jokioinen, Finland
| | - Kristiina Wähälä
- Laboratory of Organic Chemistry, Department of Chemistry, University of Helsinki, Helsinki, Finland
| | - Pirjo Mattila
- Natural Resources Institute Finland, Bio-based Business and Industry, Jokioinen, Finland
| | - Antti Jula
- Department of Health, National Institute for Health and Welfare, Turku, Finland; Department of Medicine, University of Turku, Turku, Finland.
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Dower JI, Geleijnse JM, Kroon PA, Philo M, Mensink M, Kromhout D, Hollman PCH. Does epicatechin contribute to the acute vascular function effects of dark chocolate? A randomized, crossover study. Mol Nutr Food Res 2016; 60:2379-2386. [DOI: 10.1002/mnfr.201600045] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 02/05/2023]
Affiliation(s)
- James I. Dower
- Top Institute Food and Nutrition; Wageningen The Netherlands
- Division of Human Nutrition; Wageningen University; Wageningen The Netherlands
| | - Johanna M. Geleijnse
- Top Institute Food and Nutrition; Wageningen The Netherlands
- Division of Human Nutrition; Wageningen University; Wageningen The Netherlands
| | - Paul A. Kroon
- Food and Health Programme; Institute of Food Research; Norwich Research Park; Norwich UK
| | - Mark Philo
- Food and Health Programme; Institute of Food Research; Norwich Research Park; Norwich UK
| | - Marco Mensink
- Division of Human Nutrition; Wageningen University; Wageningen The Netherlands
| | - Daan Kromhout
- Division of Human Nutrition; Wageningen University; Wageningen The Netherlands
| | - Peter C. H. Hollman
- Top Institute Food and Nutrition; Wageningen The Netherlands
- Division of Human Nutrition; Wageningen University; Wageningen The Netherlands
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Abstract
Hypertension is the leading cause of early mortality in the world, and reduction of blood pressure can help to reduce that burden. There is an enormous and ever-expanding body of literature on hypertension, with a 2016 Medline search for hypertension retrieving more than 113,000 publications. Recent guidelines from major societies have been published, and often present conflicting recommendations based on the same data. Using a question-and-answer format, this article reviews some of the recent developments and opinions on management of blood pressure and provides practical suggestions for management in the clinical arena.
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Affiliation(s)
- Leonard A Mankin
- Department of Graduate Medical Education, Legacy Health, 1200 Northwest 23rd Avenue, Portland, OR 97210, USA.
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Jang S, Sun J, Chen P, Lakshman S, Molokin A, Harnly JM, Vinyard BT, Urban JF, Davis CD, Solano-Aguilar G. Flavanol-Enriched Cocoa Powder Alters the Intestinal Microbiota, Tissue and Fluid Metabolite Profiles, and Intestinal Gene Expression in Pigs. J Nutr 2016; 146:673-80. [PMID: 26936136 PMCID: PMC4807644 DOI: 10.3945/jn.115.222968] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 01/12/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Consumption of cocoa-derived polyphenols has been associated with several health benefits; however, their effects on the intestinal microbiome and related features of host intestinal health are not adequately understood. OBJECTIVE The objective of this study was to determine the effects of eating flavanol-enriched cocoa powder on the composition of the gut microbiota, tissue metabolite profiles, and intestinal immune status. METHODS Male pigs (5 mo old, 28 kg mean body weight) were supplemented with 0, 2.5, 10, or 20 g flavanol-enriched cocoa powder/d for 27 d. Metabolites in serum, urine, the proximal colon contents, liver, and adipose tissue; bacterial abundance in the intestinal contents and feces; and intestinal tissue gene expression of inflammatory markers and Toll-like receptors (TLRs) were then determined. RESULTS O-methyl-epicatechin-glucuronide conjugates dose-dependently increased (P< 0.01) in the urine (35- to 204-fold), serum (6- to 186-fold), and adipose tissue (34- to 1144-fold) of pigs fed cocoa powder. The concentration of 3-hydroxyphenylpropionic acid isomers in urine decreased as the dose of cocoa powder fed to pigs increased (75-85%,P< 0.05). Compared with the unsupplemented pigs, the abundance ofLactobacillusspecies was greater in the feces (7-fold,P= 0.005) and that ofBifidobacteriumspecies was greater in the proximal colon contents (9-fold,P= 0.01) in pigs fed only 20 or 10 g cocoa powder/d, respectively. Moreover, consumption of cocoa powder reducedTLR9gene expression in ileal Peyer's patches (67-80%,P< 0.05) and mesenteric lymph nodes (43-71%,P< 0.05) of pigs fed 2.5-20 g cocoa powder/d compared with pigs not supplemented with cocoa powder. CONCLUSION This study demonstrates that consumption of cocoa powder by pigs can contribute to gut health by enhancing the abundance ofLactobacillusandBifidobacteriumspecies and modulating markers of localized intestinal immunity.
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Affiliation(s)
| | - Jianghao Sun
- Food Composition and Methods Development Laboratory
| | - Pei Chen
- Food Composition and Methods Development Laboratory
| | | | | | | | - Bryan T Vinyard
- Biometrical Consulting Services, USDA, Northeast Area, Beltsville Human Nutrition Research Center, Beltsville, MD; and
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Ibero-Baraibar I, Suárez M, Arola-Arnal A, Zulet MA, Martinez JA. Cocoa extract intake for 4 weeks reduces postprandial systolic blood pressure response of obese subjects, even after following an energy-restricted diet. Food Nutr Res 2016; 60:30449. [PMID: 27037002 PMCID: PMC4818356 DOI: 10.3402/fnr.v60.30449] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/24/2016] [Accepted: 01/25/2016] [Indexed: 12/27/2022] Open
Abstract
Background Cardiometabolic profile is usually altered in obesity. Interestingly, the consumption of flavanol-rich foods might be protective against those metabolic alterations. Objective To evaluate the postprandial cardiometabolic effects after the acute consumption of cocoa extract before and after 4 weeks of its daily intake. Furthermore, the bioavailability of cocoa extract was investigated. Design Twenty-four overweight/obese middle-aged subjects participated in a 4-week intervention study. Half of the volunteers consumed a test meal enriched with 1.4 g of cocoa extract (415 mg flavanols), while the rest of the volunteers consumed the same meal without the cocoa extract (control group). Glucose and lipid profile, as well as blood pressure and cocoa metabolites in plasma, were assessed before and at 60, 120, and 180 min post-consumption, at the beginning of the study (Postprandial 1) and after following a 4-week 15% energy-restricted diet including meals containing or not containing the cocoa extract (Postprandial 2). Results In the Postprandial 1 test, the area under the curve (AUC) of systolic blood pressure (SBP) was significantly higher in the cocoa group compared with the control group (p=0.007), showing significant differences after 120 min of intake. However, no differences between groups were observed at Postprandial 2. Interestingly, the reduction of postprandial AUC of SBP (AUC_Postprandial 2-AUC_Postprandial 1) was higher in the cocoa group (p=0.016). Furthermore, cocoa-derived metabolites were detected in plasma of the cocoa group, while the absence or significantly lower amounts of metabolites were found in the control group. Conclusions The daily consumption of cocoa extract within an energy-restricted diet for 4 weeks resulted in a greater reduction of postprandial AUC of SBP compared with the effect of energy-restricted diet alone and independently of body weight loss. These results suggest the role of cocoa flavanols on postprandial blood pressure homeostasis.
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Affiliation(s)
- Idoia Ibero-Baraibar
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain.,Centre for Nutrition Research, Faculty of Pharmacy, University of Navarra, Pamplona, Spain
| | - Manuel Suárez
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Tarragona, Spain.,Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS, Reus, Spain
| | - Anna Arola-Arnal
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Tarragona, Spain.,Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS, Reus, Spain
| | - M Angeles Zulet
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain.,Centre for Nutrition Research, Faculty of Pharmacy, University of Navarra, Pamplona, Spain.,Physiopathology of Obesity and Nutrition, CIBERobn, Carlos III Health Research Institute, Madrid, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain.,Centre for Nutrition Research, Faculty of Pharmacy, University of Navarra, Pamplona, Spain.,Physiopathology of Obesity and Nutrition, CIBERobn, Carlos III Health Research Institute, Madrid, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain;
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48
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Borghi C, Cicero AFG. Nutraceuticals with a clinically detectable blood pressure-lowering effect: a review of available randomized clinical trials and their meta-analyses. Br J Clin Pharmacol 2016; 83:163-171. [PMID: 26852373 DOI: 10.1111/bcp.12902] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/02/2016] [Accepted: 02/02/2016] [Indexed: 12/19/2022] Open
Abstract
AIMS The aim of the present study was to review and comment on the available evidence on nutraceuticals with a clinically demonstrable blood pressure (BP)-lowering effect. METHODS We reviewed studies published in the English language from 1990 to 2015 on dietary supplements or nutraceuticals claiming to show an effect on human BP. An initial list of possibly effective agents and studies was obtained from the online reference, the Natural Medicine Comprehensive Database. Using PubMed, we searched agents identified from this list using the MeSH terms 'hypertension', 'blood pressure', 'dietary supplement' and 'nutraceuticals', alone and in combination. We then focused our attention on meta-analyses and randomized clinical trials. RESULTS Beyond the well-known effects on BP of the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet, a large number of studies have investigated the possible BP-lowering effect of different dietary supplements and nutraceuticals, most of which are antioxidant agents with a high tolerability and safety profile. In particular, a relatively large body of evidence supports the use of potassium, magnesium, L-arginine, vitamin C, cocoa flavonoids, beetroot juice, coenzyme Q10, controlled-release melatonin and aged garlic extract. The antihypertensive effect of all these nutraceuticals seems to be dose related and the overall tolerability is good. CONCLUSION Some nutraceuticals might have a positive impact on BP in humans. Further clinical research is needed, to identify from the available active nutraceuticals those with the best cost-effectiveness and risk-benefit ratio for widespread and long-term use in the general population with a low-added cardiovascular risk related to uncomplicated hypertension.
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Affiliation(s)
- Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, University of Bologna, Italy
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Warner EF, Zhang Q, Raheem KS, O'Hagan D, O'Connell MA, Kay CD. Common Phenolic Metabolites of Flavonoids, but Not Their Unmetabolized Precursors, Reduce the Secretion of Vascular Cellular Adhesion Molecules by Human Endothelial Cells. J Nutr 2016; 146:465-73. [PMID: 26843586 PMCID: PMC4763483 DOI: 10.3945/jn.115.217943] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/20/2015] [Accepted: 12/29/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Flavonoids have been implicated in the prevention of cardiovascular disease; however, their mechanisms of action have yet to be elucidated, possibly because most previous in vitro studies have used supraphysiological concentrations of unmetabolized flavonoids, overlooking their more bioavailable phenolic metabolites. OBJECTIVE We aimed to explore the effects of phenolic metabolites and their precursor flavonoids at physiologically achievable concentrations, in isolation and combination, on soluble vascular cellular adhesion molecule-1 (sVCAM-1). METHOD Fourteen phenolic acid metabolites and 6 flavonoids were screened at 1 μM for their relative effects on sVCAM-1 secretion by human umbilical vein endothelial cells stimulated with tumor necrosis factor alpha (TNF-α). The active metabolites were further studied for their response at different concentrations (0.01 μM-100 μM), structure-activity relationships, and effect on vascular cellular adhesion molecule (VCAM)-1 mRNA expression. In addition, the additive activity of the metabolites and flavonoids was investigated by screening 25 unique mixtures at cumulative equimolar concentrations of 1 μM. RESULTS Of the 20 compounds screened at 1 μM, inhibition of sVCAM-1 secretion was elicited by 4 phenolic metabolites, of which protocatechuic acid (PCA) was the most active (-17.2%, P = 0.05). Investigations into their responses at different concentrations showed that PCA significantly reduced sVCAM-1 15.2-36.5% between 1 and 100 μM, protocatechuic acid-3-sulfate and isovanillic acid reduced sVCAM-1 levels 12.2-54.7% between 10 and 100 μM, and protocatechuic acid-4-sulfate and isovanillic acid-3-glucuronide reduced sVCAM-1 secretion 27.6% and 42.8%, respectively, only at 100 μM. PCA demonstrated the strongest protein response and was therefore explored for its effect on VCAM-1 mRNA, where 78.4% inhibition was observed only after treatment with 100 μM PCA. Mixtures of the metabolites showed no activity toward sVCAM-1, suggesting no additive activity at 1 μM. CONCLUSIONS The present findings suggest that metabolism of flavonoids increases their vascular efficacy, resulting in a diversity of structures of varying bioactivity in human endothelial cells.
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Affiliation(s)
| | - Qingzhi Zhang
- School of Chemistry, University of St. Andrews, St. Andrews, United Kingdom; and
| | - K Saki Raheem
- School of Chemistry, University of St. Andrews, St. Andrews, United Kingdom; and Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
| | - David O'Hagan
- School of Chemistry, University of St. Andrews, St. Andrews, United Kingdom; and
| | - Maria A O'Connell
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Colin D Kay
- Department of Nutrition, Norwich Medical School, and
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Barokah L, Baktiyani SCW, Kalsum U. Protective effect of Theobroma cacao on nitric oxide and endothelin-1 level in endothelial cells induced by plasma from preeclamptic patients: In silico and in vitro studies. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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