Antioxidant effects of vitamin E and risk of cardiovascular disease in women with obesity – a narrative review

Vitamin E and cardiovascular diseases: an interest to public health?

Cardiovascular diseases (CVD) are the leading cause of death worldwide. From this perspective, the role of vitamin E and its metabolites in preventing CVD has been studied, being supported by the findings that low vitamin E concentrations are associated with an increased risk of cardiovascular events. Despite this, no studies have analysed the co-existence of vitamin E deficiency (VED) and CVD on the basis of population studies. Facing that, this study summarises information on the relationship between vitamin E status and CVD, providing a basis for understanding the determining and protective factors for its development. VED may be a public health problem since it has been observed to vary from 0·6% to 55·5% worldwide, with higher percentages in Asia and Europe, where CVD mortality rates stand out. Intervention studies with α-tocopherol supplementation do not confirm cardioprotective action of vitamin E, which may reflect that α-tocopherol alone does not provide cardiovascular protection to individuals, but the consumption of all isomers found in food. Considering that low concentrations of α-tocopherol can lead to a higher susceptibility to diseases involving oxidative stress in the population, in addition to the high and growing prevalence of CVD and VED, it is essential to investigate or reinterpret the mechanisms of action of vitamin E and its metabolites in the cardiovascular process to better understand the co-existence of CVD and VED. It is also important to implement public health policies and programmes aimed at promoting the consumption of natural food sources of vitamin E and healthy fats.

Correction of plasma fat-soluble vitamin levels by blood lipids in elderly patients with coronary heart disease

This study aims to investigate the correlation between plasma fat-soluble vitamin levels and blood lipid in elderly patients with coronary heart disease (CHD). A total of 120 participants were enrolled, including 60 CHD patients and 60 controls without CHD. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to quantify plasma levels of vitamins A, D3, E, and K. Data analysis was conducted using the statistical analysis system module of MetaboAnalyst 5.0. The CHD group showed significantly higher levels of plasma total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) but not high-density lipoprotein cholesterol (HDL-C) compared to controls. The CHD group exhibited significantly higher plasma levels of VA and VE, positively correlating with TC, TG, and LDL-C. After adjusted by TG levels, the CHD group had significantly lower plasma levels of VA and VE, negatively correlating with TC, TG, and LDL-C. The CHD group also had significantly lower concentrations of VD3, independent of TG modification, compared to controls. VD3 negatively correlated with TC, TG, and LDL-C. Elderly individuals with CHD display abnormal blood lipid metabolism, and fat-soluble vitamins adjusted by TG levels can more accurately and timely response to implicit fat-soluble vitamins deficiency in CHD patients.

Vitamin D/Bone Mineral Density and Triglyceride Paradoxes Seen in African Americans: A Cross-Sectional Study and Review of the Literature

Vitamin D is known to have a positive effect on bone health. Despite the greater frequency of vitamin D deficiency in African Americans (AA), they have a higher bone mineral density (BMD) compared to whites, demonstrating a disconnect between BMD and vitamin D levels in AA. Another intriguing relationship seen in AA is the triglyceride (TG) paradox, an unusual phenomenon in which a normal TG status is observed even when patients house conditions known to be characterized by high TG levels, such as Type II diabetes. To the best of our knowledge, no study has examined whether these two paradoxical relationships exist simultaneously in AA subjects with Type II diabetes. In this study, we compared levels of blood markers, including HbA1c, TG, and vitamin D, measured as serum 25-hydroxyvitamin D [25(OH)VD] µM/mL, [25(OH)VD]/TG, calcium, and BMD in AA (n = 56) and white (n = 26) subjects with Type II diabetes to see whether these relationships exist concurrently. We found that AA subjects had significantly lower TG and [25(OH)VD] levels and a significantly higher BMD status compared to white subjects, even when the ages, BMI, duration of diabetes, HbA1c, and calcium levels were similar between the two groups. This demonstrates that these two paradoxical relationships exist simultaneously in Type II diabetic AA subjects. In addition to these findings, we discuss the current hypotheses in the literature that attempt to explain why these two intriguing relationships exist. This review also discusses four novel hypotheses, such as altered circulating levels and the potential role of estrogen and hydrogen sulfide on BMD and HMG-CoA reductase as a possible contributor to the TG paradox in AA subjects. This manuscript demonstrates that there are still many unanswered questions regarding these two paradoxical relationships and further research is needed to determine why they exist and how they can be implemented to improve healthcare.

Association between vitamin levels and obesity in the national health and nutrition examination surveys 2017 to 2018

In recent years, the rapidly increasing incidence of obesity is becoming a worldwide public health problem. Obesity is a chronic disease which may have a major negative effect on the people's quality of life. Previous studies on the comprehensive effects of multivitamins on central obesity and general obesity are relatively few. The aim of this study was to evaluate association of vitamins exposure with obesity risk and obesity-related indicators. We fitted three statistical models (linear regression model, logistic regression model, and Bayesian kernel machine regression model) to evaluate the correlation between vitamin levels and obesity in the study population. The vitamin score represents the overall level of vitamin in serum, which was mutually verified with the results obtained from statistical model. The vitamin (A, C, and D) levels were significantly higher among non-obesity group compared to the obesity group. Using the lowest quartile of vitamin level as a referent, vitamin A, C, and D levels showed significantly negative correlation with the obesity risk in both adjusted and unadjusted models. When considering all vitamin as a mixed exposure, we found a generally negative relationship between vitamin mixtures with binary outcome (obesity) and continuous outcome (BMI, waist circumference, and hsCRP). Reduced levels of vitamins (A, C and D) increased the risk of obesity. Increased levels of vitamin mixtures can significantly reduce obesity risk and obesity-related indicators. Vitamins may reduce the risk of obesity by suppressing inflammatory responses.

Neuroprotective and Cardiometabolic Role of Vitamin E: Alleviating Neuroinflammation and Metabolic Disturbance Induced by AlCl3 in Rat Models

Cardiovascular diseases (CVDs) and neurodegenerative disorders, such as diabetes mellitus and Alzheimer's disease, share a common pathophysiological link involving insulin resistance (IR), inflammation, and hypertension. Aluminium chloride (AlCl3), a known neurotoxicant, has been associated with neurodegeneration, cognitive impairment, and various organ dysfunctions due to the production of reactive oxygen species (ROS) and oxidative stress. In this study, we aimed to investigate the potential protective effects of metformin and vitamin E against AlCl3-induced neuroinflammation and cardiometabolic disturbances in rat models. Rats were divided into five groups: a normal control group, an AlCl3-treated diseased group without any treatment, and three groups exposed to AlCl3 and subsequently administered with metformin (100 mg/kg/day) alone, vitamin E (150 mg/kg/day) orally alone, or a combination of metformin (100 mg/kg/day) and vitamin E (150 mg/kg/day) for 45 days. We analyzed serum biomarkers and histopathological changes in brain, heart, and pancreatic tissues using H&E and Masson's trichrome staining and immunohistochemistry (IHC). Electrocardiogram (ECG) patterns were observed for all groups. The AlCl3-treated group showed elevated levels of inflammatory biomarkers, MDA, and disturbances in glycemic and lipid profiles, along with reduced insulin levels. However, treatment with the combination of metformin and vitamin E resulted in significantly reduced glucose, cholesterol, LDL, and TG levels, accompanied by increased insulin and HDL levels compared to the individual treatment groups. Histopathological analyses revealed that combination therapy preserved neuronal structures, muscle cell nuclei, and normal morphology in the brain, heart, and pancreatic tissues. IHC demonstrated reduced amyloid plaques and neurofibrillary tangles in the combination-treated group compared to the AlCl3-treated group. Moreover, the combination group showed a normal ECG pattern, contrasting the altered pattern observed in the AlCl3-treated group. Overall, our findings suggest that metformin and vitamin E, in combination, possess neuroprotective and cardiometabolic effects, alleviating AlCl3-induced neuroinflammation and metabolic disturbances.

Characterization of Wei Safflower Seed Oil Using Cold-Pressing and Solvent Extraction

Wei safflower seed oil (WSO) prepared by the cold pressing method and organic solvent extraction method was characterized in this study. The yield of cold-pressed WSO (CP-WSO) was inferior to that of n-hexane-extracted WSO (HE-WSO). The physicochemical properties (refractive index, density, iodine value, insoluble impurities) and fatty acid compositions were similar, and both were rich in linoleic acid. However, CP-WSO had better color and less solvent residue. The type and content of vitamin E in CP-WSO was also superior to that in HE-WSO, which explained the high oxidative stability of CP-WSO in the Rancimat test. Our results provide a reference for the development of Wei safflower seed oil.

Vitamin E and Multiple Health Outcomes: An Umbrella Review of Meta-Analyses

The relationship between vitamin E intake or circulating α-tocopherol and various health outcomes is still debatable and uncertain. We conducted an umbrella review to identify the relationships between vitamin E intake or circulating tocopherol and health outcomes by merging and recalculating earlier meta-analyses. The connections that were found to be statistically significant were then classified into different evidence levels based on p values, between-study heterogeneity, prediction intervals, and small study effects. We finally included 32 eligible meta-analyses with four vitamin E sources and 64 unique health outcomes. Only the association between circulating α-tocopherol and wheeze or asthma in children was substantiated by consistent evidence. Suggestive evidence was suggested for seven results on endothelial function (supplemental vitamin E): serum C-reactive protein (CRP) concentrations (supplemental vitamin E), cervical cancer (dietary vitamin E), esophageal cancer (dietary vitamin E), cervical intraepithelial neoplasia (CIN, dietary vitamin E), pancreatic cancer (total vitamin E intake), and colorectal cancer (circulating α-tocopherol levels); all of these showed a protective effect consistent with the vitamin E source. In conclusion, our work has indicated that vitamin E is protective for several particular health outcomes. Further prospective studies are required when other factors that may contribute to bias are considered.

The role played by oral antioxidant therapies in preventing and treating preeclampsia: An updated meta-analysis

AIMS

Performing an up-to-date meta-analysis of oral antioxidant therapies and determining whether they are effective in preventing and/or treating preeclampsia (PE).

DATA SYNTHESIS

Search was performed in PubMed, CENTRAL, LILACS, Web of Science, and ScienceDirect databases. The risk of bias was assessed based on using Cochrane Collaboration's tool. A funnel plot was created, and Egger's and Peter's test was carried out to assess publication bias in the primary outcome of prevention studies. The overall quality of the evidence was assessed based on using the Grading of Recommendations Assessment, Developing and Evaluation (GRADE) tool; a formal protocol was published in the PROSPERO database (registration number CRD42022348992). In total, 32 studies were taken into consideration for analysis purposes; 22 studies focused on investigating preeclampsia prevention methods, whereas 10 focused on its treatment. Significant results associated with the incidence of preeclampsia were observed in prevention studies comprising 11,198 subjects and 1106 events in the control groups, as well as 11,156 subjects and 1048 events in the intervention groups (relative risk [RR]: 0.86, 95% confidence interval [CI]: [0.75, 0.99], P = 0.03; I² = 44%, P = 0.02). With respect to outcomes associated with treatment studies, only intrauterine growth restriction has shown significant effects. Egger's and Peter's test has evidenced publication bias. Six outcomes in prevention studies were classified as having low quality and two as having moderate quality, whereas all three outcomes assessed in treatment studies were classified as having moderate quality.

CONCLUSIONS

Antioxidant therapy has shown beneficial effects on preeclampsia prevention; moreover, the positive impact of this therapy on intrauterine growth restriction was observed during the disease treatment.

Koelreuteria paniculata Seed Oil-A Rich Natural Source of Unsaturated Fatty Acids and Phytocompounds with DNA Protective Potential

The present work is focused on the physicochemical characteristics, chemical composition, and some biological activities of Koelreuteria paniculata seed oil. The glyceride oil, obtained with a Soxhlet apparatus by extraction with hexane, was characterized by a relatively high oil content (over 20%), and it is defined as a non-drying oil (iodine value-44 gI₂/100 g) with good oxidative stability (over 50 h). There were identified 11 fatty acids, 6 sterols, 3 tocopherols, and 6 phospholipids, as the last group was reported for the first time. The major components among them were-monounsaturated eicosenoic and oleic acids, β-sitosterol, β-tocopherol, and phosphatidylcholine. The in vitro tests demonstrated DNA protective activity and a lack of cytotoxicity of the oil, data that has been reported for the first time. The in vitro MTT test of the oil on HT-29 and PC3 cell lines did not indicate antitumor activity. The seed oil studied contains valuable bio-components, which have proven benefits for human health, and that is why it could be used in food, cosmetic, and pharmaceutical products.

Edible mushrooms as potential functional foods in amelioration of hypertension

Edible mushrooms are popular functional foods attributed to their rich nutritional bioactive constituent profile influencing cardiovascular function. Edible mushrooms are omnipresent in various prescribed Dietary Approaches to Stop Hypertension, Mediterranean diet, and fortified meal plans as they are rich in amino acids, dietary fiber, proteins, sterols, vitamins, and minerals. However, without an understanding of the influence of mushroom bioactive constituents, mechanism of action on heart and allergenicity, it is difficult to fully comprehend the role of mushrooms as dietary interventions in alleviating hypertension and other cardiovascular malfunctions. To accomplish this endeavor, we chose to review edible mushrooms and their bioactive constituents in ameliorating hypertension. Hypertension and cardiovascular diseases are interrelated and if the former is managed by dietary changes, it is postulated that overall heart health could also be improved. With a concise note on different edible varieties of mushrooms, a particular focus is presented on the antihypertensive potential of mushroom bioactive constituents, mode of action, absorption kinetics and bioavailability. Ergosterol, lovastatin, cordycepin, tocopherols, chitosan, ergothioneine, γ-aminobutyric acid, quercetin, and eritadenine are described as essential bioactives with hypotensive effects. Finally, safety concerns on allergens and limitations of consuming edible mushrooms with special reference to chemical toxins and their postulated metabolites are highlighted. It is opined that the present review will redirect toxicologists to further investigate mushroom bioactives and allergens, thereby influencing dietary interventions for heart health.

Dietary Antioxidants, Quality of Nutrition and Cardiovascular Characteristics among Omnivores, Flexitarians and Vegetarians in Poland-The Results of Multicenter National Representative Survey WOBASZ

Several reports have shown that more plant-based dietary patterns provide a higher intake of antioxidants compared to diets rich in meat and animal products. Data on the intake of key nutrients in cardiovascular disease (CVD) prevention in relation to particular diets in countries of Central and Eastern Europe are scarce. The aim of this study was to assess quality of nutrition and CVD characteristics in a representative sample of Polish adults following different dietary patterns. Special regard was paid to the intake of natural antioxidants. The study comprised 13,318 (7159 females) randomly selected adults aged ≥ 20 years participating in the National Multicentre Health Surveys WOBASZ and WOBASZ II. The subjects were categorized into groups of omnivores (92.4%), flexitarians (7.4%) and vegetarians (0.16%) according to type of diet using the Food Frequency Questionnaire and 24 h dietary recall. The obtained results showed that neither flexitarians nor vegetarians represented better dietary habits or lifestyle behaviors compared to omnivores. Flexitarians had significantly lower daily energy intake than omnivores, but their diet was rich in total fat (above 30% of daily energy consumption) and low in fiber. Omnivores declared a higher consumption of fresh vegetables (p < 0.001), fresh fruit (p < 0.01), coffee (p < 0.01) and tea (p < 0.05, in women only) than flexitarians. Omnivores had significantly higher intake of natural antioxidants (vitamin C, E, zinc in both genders and vitamin A in men) as compared with flexitarians. Among women, the highest adherence to the intake of recommended amounts of antioxidant nutrients was noted among omnivores. Among men, vegetarians had the highest proportion of meeting the guidelines for vitamin A (77.8%), E (66.7%) and C (66.7%), while the lowest proportions were found in flexitarians (69.9%, 39.5% and 32.4%, respectively). The groups did not differ in terms of smoking and physical activity level. There were no significant differences in the analyzed CVD characteristics between omnivores and flexitarians. In women, vegetarians had substantially lower BMI than omnivores (p < 0.05) and flexitarians (p < 0.05) and a lower mean serum glucose compared with omnivores (p < 0.01) and flexitarians (p < 0.05). Vegetarians had lower prevalence of hypertension and obesity than meat eaters. In conclusion, the results of the current research showed an inappropriate intake of several nutrients, including highly potent antioxidants, irrespective of the dietary regimen. Flexitarians did not have a more favorable CVD profile than omnivores. Taking into account the growing popularity of diets with reduced animal products, there is a need to elaborate strategies providing Polish adults with guidance regarding properly balanced nutrition.

Comparative analysis of the degree of hydrolysis and antioxidant activity of milk and whey hydrolysates

The degree of hydrolysis and antioxidant activity of protein hydrolysates from fresh cow’s milk and whey obtained by the action of the proteolytic enzymes papain, bromelain and chymosin were compared. The lowest degree of hydrolysis in fresh milk hydrolysates was reported for sample MP1 (10 min reaction time, treatment with 0.1 mg/ml papain), and the highest percentage was obtained at hydrolysate MB12 (at 60 min reaction time, treatment with 1.0 mg/ml bromelain). For the whey samples in sample WC1 (10 min reaction time, treatment with 1.0 μl/ml chymosin), the percentage of hydrolysis was the lowest. The highest percentage was achieved at WP12 hydrolysate using papain at a concentration of 1 mg/ml and a 60-min reaction time. The obtained values for the antioxidant capacity of the hydrolysed products show a higher activity compared to the starting substrates. The highest activity in the milk hydrolysates of 11.32 mg TE/100 ml was found in variant MB3, and in the whey hydrolysates of 7.83 mg TE/100 ml - in variant WP7. Hydrolysates treated with chymosin had lower TE values compared to the hydrolysate’s variants, treated with papain and bromelain.

Role of Vitamins in Cardiovascular Health: Know Your Facts-Part 2

Cardiovascular disease (CVD) is a major cause of morbidity/mortality world-wide, hence preventive interventions are crucial. Observational data showing beneficial CV effects of vitamin supplements, promoted by self-proclaimed experts, have led to ~50% of Americans using multivitamins; this practice has culminated into a multi-billion-dollar business. However, robust evidence is lacking, and certain vitamins might incur harm. This two-part review focuses on the attributes or concerns about specific vitamin consumption on CVD. The evidence for indiscriminate use of multivitamins indicates no consistent CVD benefit. Specific vitamins and/or combinations are suggested, but further supportive evidence is needed. Data presented in Part 1 indicated that folic acid and certain B-vitamins may decrease stroke, whereas niacin might raise mortality; beta-carotene mediates pro-oxidant effects, which may abate the benefits from other vitamins. In Part 2, data favor the anti-oxidant effects of vitamin C and the anti-atherogenic effects of vitamins C and E, but clinical evidence is inconsistent. Vitamin D may provide CV protection, but data are conflicting. Vitamin K appears neutral. Thus, there are favorable CV effects of individual vitamins (C/D), but randomized/controlled data are lacking. An important caveat regards the potential toxicity of increased doses of fat-soluble vitamins (A/D/E/K). As emphasized in Part 1, vitamins might benefit subjects who are antioxidant-deficient or exposed to high levels of oxidative-stress (e.g., diabetics, smokers, and elderly), stressing the importance of targeting certain subgroups for optimal results. Finally, by promoting CV-healthy balanced-diets, we could acquire essential vitamins and nutrients and use supplements only for specific indications.

Physical Activity and Diet in Older Women: A Narrative Review

Physical activity and diet are essential for maintaining good health and preventing the development of non-communicable diseases, especially in the older adults. One aspect that is often over-looked is the different response between men and women to exercise and nutrients. The body's response to exercise and to different nutrients as well as the choice of foods is different in the two sexes and is strongly influenced by the different hormonal ages in women. The present narrative review analyzes the effects of gender on nutrition and physical activity in older women. Understanding which components of diet and physical activity affect the health status of older women would help target non-pharmacological but lifestyle-related therapeutic interventions. It is interesting to note that this analysis shows a lack of studies dedicated to older women and a lack of studies dedicated to the interactions between diet and physical activity in women. Gender medicine is a current need that still finds little evidence.

Preparation and antioxidant activity of novel chitosan oligosaccharide quinolinyl urea derivatives

In the present study, four new chitosan oligosaccharide derivatives bearing quinolinyl urea groups were synthesized by reaction between 2-methoxyformylated chitosan oligosaccharide and aminoquinoline. The chitosan oligosaccharide derivatives were characterized by Fourier Transform Infrared (FTIR) and 1H Nuclear Magnetic Resonance (1H NMR) spectroscopy. The obtained results confirmed that chitosan oligosaccharide quinolinyl urea derivatives were successfully synthesized. Meanwhile, the antioxidant activities of different chitosan oligosaccharide derivatives were examined in vitro. Experimentally, it was demonstrated that chitosan oligosaccharide quinolinyl urea derivatives had superior antioxidant activity compared with chitosan oligosaccharide and the antioxidant effects were concentration-dependent. Especially, when the concentration was 1.6 mg/mL, their superoxide anion radical scavenging rates could reach to 72.35 ± 0.49%, 100.00 ± 0.21%, 84.63 ± 0.49%, and 87.22 ± 0.32%, respectively. And the hydroxyl radical scavenging rates could reach to 100.00 ± 0.82%, 98.49 ± 4.08%, 100.00 ± 5.76%, and 92.07 ± 5.10%. In addition, the cytotoxic activity of the prepared chitosan derivatives against L929 cells was determined by CCK-8 assay. The cell survival rates were all higher than 90%, which intuitively indicated that the samples had almost no cytotoxicity. The findings indicated that the enhanced antioxidant property and biocompatibility of these chitosan oligosaccharide quinolinyl urea derivatives could enlarge the scope of the application of chitosan oligosaccharide, particularly as an antioxidant in food packaging, biomedical, pharmaceutical, cosmetics industries and other fields.

The Effect of the Addition of Hemp Seeds, Amaranth, and Golden Flaxseed on the Nutritional Value, Physical, Sensory Characteristics, and Safety of Poultry Pâté

Food producers’ interest in improving the nutritional and pro-health values of meat products has grown. The study aims to assess the effect of replacing poultry pâté products wheat roll (24% group I) in recipes with a mixture of hemp seeds (8% each in groups II, III, IV), amaranth (10% group II, 6% group III, 8% group IV) and golden flaxseed (6% group II, 10% group III, 8% group IV). The quality assessment covered nutritional value, physical properties, the total number of bacteria and assessment of sensory characteristics. The findings indicate that replacing wheat roll with seed mixtures increased the nutritional value (protein, ash, fat, proportion of polyunsaturated and polyene acids) of pâtés in all groups while decreasing the proportion of saturated fatty acids and the ratio of omega-6/omega-3 acids (3:1). This resulted in enhanced brightness and hardness pâtés, as well as greater microbiological safety. Although the spread and firmness of pâtés with seed addition were rated lower than the control, their taste desirability and bonding were rated highest for pâté with 8% plant additives. Pâtés with 24% hemp, amaranth and flaxseed mixture fulfil the requirements to be referred to as functional meat products.