Effects of acute intake of grape/pomegranate pomace dietary supplement on glucose metabolism and oxidative stress in adults with abdominal obesity

Health-Promoting Properties and the Use of Fruit Pomace in the Food Industry-A Review

Fruit pomace, a by-product of the fruit industry, includes the skins, seeds, and pulp most commonly left behind after juice extraction. It is produced in large quantities: apple residues alone generate approximately 4 million tons of waste annually, which is a serious problem for the processing industry but also creates opportunities for various applications. Due to, among other properties, their high content of dietary fiber and polyphenolic compounds, fruit residues are used to design food with functional features, improving the nutritional value and health-promoting, technological, and sensory properties of food products. This article presents the health-promoting (antioxidant, antidiabetic, anti-inflammatory, and antibacterial) properties of fruit pomace. Moreover, the possibilities of their use in the food industry are characterized, with particular emphasis on bread, sweet snack products, and extruded snacks. Attention is paid to the impact of waste products from the fruit industry on the nutritional value and technological and sensory characteristics of these products. Fruit pomace is a valuable by-product whose use in the food industry can provide a sustainable solution for waste management and contribute to the development of functional food products with targeted health-promoting properties.

Reporting of adverse effects of pomegranate in clinical studies: a systematic review

OBJECTIVES

Numerous studies have shown the pharmacological effects of pomegranate, such as: anti-cancer, cholesterol-lowering, anti-diabetic, and antihypertensive features. Pomegranate consumption has also revealed some adverse effects. This systematic review aimed to explore the adverse effects of pomegranate reported in clinical studies.

CONTENT

The keywords "pomegranate", "Punica granatum", "side effect", "clinical trial", and "case report or case series" were searched for in valid databases. Reports about adverse effects of pomegranate were also collected from several international registries.

SUMMARY

This systematic review included a total of 66 clinical articles. Eleven articles have reported side effects of pomegranate. Twenty-one articles have recorded no side effects in the pomegranate group while 34 articles have not mentioned any side effects for this plant. The study also included 7 case report studies. The most common side effects included gastrointestinal problems, flu-like symptoms, and urinary problems. In case report studies, the most significant reported side effect was allergic reaction.

OUTLOOK

In summary, pomegranate and its extract seem to be safe according to the reported adverse effects. Meanwhile, conducting more robust controlled trials with pomegranate products and documentation of any probable side effect is warranted.

Plant bioactive compounds from Mediterranean diet improve risk factors for metabolic syndrome

Mediterranean (Med) dietary pattern consists of moderate or high consumption of foods that are linked to reduced risk factors for metabolic syndrome (MetS). This comprehensive review evaluates studies on Med diet-representative foods and beverages, such as red wine and olive oil, to understand the inverse associations of Med diet and MetS. The intake of dietary fibre, unsaturated fatty acids, vitamins, and polyphenols - including flavonoids and stilbenes - help to explain the benefits of Med diet on abdominal adiposity, glucose intolerance, hyperlipidaemia, and high blood pressure to some extent. Antioxidant and anti-inflammatory properties of polyphenols as well as the effects of unsaturated fatty acids on lipid metabolism are part of the underlying mechanisms. Overall, this review shows that dietary interventions using Med diet components improve MetS health markers in humans and/or rodents.

Polyphenols: a route from bioavailability to bioactivity addressing potential health benefits to tackle human chronic diseases

Chronic pathologies or non-communicable diseases (NCDs) include cardiovascular diseases, metabolic syndrome, neurological diseases, respiratory disorders and cancer. They are the leading global cause of human mortality and morbidity. Given their chronic nature, NCDs represent a growing social and economic burden, hence urging the need for ameliorating the existing preventive strategies, and for finding novel tackling therapies. NCDs are highly correlated with unhealthy lifestyle habits (such as high-fat and high-glucose diet, or sedentary life). In general, lifestyle approaches that might improve these habits, including dietary consumption of fresh vegetables, fruits and fibers, may contrast NCD symptoms and prolong life expectancy of affected people. Polyphenols (PPLs) are plant-derived molecules with demonstrated biological activities in humans, which include: radical scavenging and anti-oxidant activities, capability to modulate inflammation, as well as human enzymes, and even to bind nuclear receptors. For these reasons, PPLs are currently tested, both preclinically and clinically, as dietary adjuvants for the prevention and treatment of NCDs. In this review, we describe the human metabolism and bioactivity of PPLs. Also, we report what is currently known about PPLs interaction with gastro-intestinal enzymes and gut microbiota, which allows their biotransformation in many different metabolites with several biological functions. The systemic bioactivity of PPLs and the newly available PPL-delivery nanosystems are also described in detail. Finally, the up-to-date clinical studies assessing both safety and efficacy of dietary PPLs in individuals with different NCDs are hereby reported. Overall, the clinical results support the notion that PPLs from fruits, vegetables, but also from leaves or seeds extracts, are safe and show significant positive results in ameliorating symptoms and improving the whole quality of life of people with NCDs.

Effects of Polyphenols on Glucose-Induced Metabolic Changes in Healthy Human Subjects and on Glucose Transporters

Dietary polyphenols interact with glucose transporters in the small intestine and modulate glucose uptake after food or beverage consumption. This review assesses the transporter interaction in vitro and how this translates to an effect in healthy volunteers consuming glucose. As examples, the apple polyphenol phlorizin inhibits sodium-glucose linked transporter-1; in the intestinal lumen, it is converted to phloretin, a strong inhibitor of glucose transporter-2 (GLUT2), by the brush border digestive enzyme lactase. Consequently, an apple extract rich in phlorizin attenuates blood glucose and insulin in healthy volunteers after a glucose challenge. On the other hand, the olive phenolic, oleuropein, inhibits GLUT2, but the strength of the inhibition is not enough to modulate blood glucose after a glucose challenge in healthy volunteers. Multiple metabolic effects and oxidative stresses after glucose consumption include insulin, incretin hormones, fatty acids, amino acids, and protein markers. However, apart from acute postprandial effects on glucose, insulin, and some incretin hormones, very little is known about the acute effects of polyphenols on these glucose-induced secondary effects. In summary, attenuation of the effect of a glucose challenge in vivo is only observed when polyphenols are strong inhibitors of glucose transporters.

The Role of By-Products of Fruit and Vegetable Processing for the Dietary Treatment of Cardiovascular Risk Factors: A Narrative Review

Polyphenols-rich food has been utilized to induce a positive effect on human health. Considering that fruit and vegetable by-products (seeds, pomace, and peels) are sources of polyphenols, previous studies have investigated the effect of dietary supplementation with food by-products on cardiometabolic disorders, such as high fasting blood glucose, dyslipidemia, and obesity. Endothelial dysfunction has also been considered a cardiometabolic parameter, given that it precedes cardiovascular disease. However, there is a scarcity of narrative reviews reporting the effect of food by-product supplementation on cardiometabolic disorders in animal and human clinical trials. In this sense, the present narrative review aims to investigate the impact of fruit and vegetable by-product supplementation on cardiometabolic disorders in humans and animals, exploring the possible mechanisms whenever possible. Research articles were retrieved based on a search of the following databases: PubMed, ScienceDirect, and Google Scholar using the following keywords and synonyms combined: (“fruit by-products” or “food waste” or “pomace” or “bagasse” or “seeds” or “waste products”) AND (“heart disease risk factors” or “endothelial dysfunction” or “atherosclerosis”). It was shown that fruit and vegetable by-products could efficiently improve cardiometabolic disorders in patients with chronic diseases, including hypertension, type II diabetes mellitus, and dyslipidemia. Such effects can be induced by the polyphenols present in food by-products. In conclusion, food by-product supplementation has a positive effect on cardiometabolic disorders. However, further studies investigating the effect of food by-products on cardiometabolic disorders in humans are still necessary so that solid conclusions can be drawn.

Antioxidant and Anti-Inflammatory Actions of Polyphenols from Red and White Grape Pomace in Ischemic Heart Diseases

Grape pomace (GP) represents a very reliable source of polyphenols because it could be found globally as a remnant of the wine industry. During the winemaking process, two types of GP are generated: red GP and white GP, according to the produced wine, red or white. Grape pomace represents a viable source of polyphenols, mainly flavanols, procyanidins anthocyanins, and resveratrol which possess antioxidant and anti-inflammatory activities. Multiple differences were observed between red and white GP in terms of their antioxidant and anti-inflammatory activity in both in vitro and in vivo studies. Although most studies are focused on the antioxidant and anti-inflammatory effect of red grape pomace, there are still many variables that need to be taken into consideration, as well as extensive study of the white GP. It was observed that in both in vitro and in vivo studies, the GP polyphenols have a direct antioxidant activity by acting as a free radical scavenger or donating a hydrogen atom. It also possesses an indirect antioxidant and anti-inflammatory activity by reducing mitochondrial reactive oxygen species (ROS) generation, malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), interleukin-1-beta (IL-1β), interleukin-6 (IL-6), nuclear factor kappa-light-chain-enhancer of activated B cells (NF- κβ), and inhibitor of nuclear factor kappa-B kinase subunit beta (Iκκβ) levels or nitrate oxide-4 (NOX4) expression and by increasing the levels of antioxidants enzymes like superoxide dismutase (SOD), catalase (CAT) glutathione reductase (GRx) and glutathione peroxidase(GPx). Besides these activities, many beneficial effects in ischemic heart diseases were also observed, such as the maintenance of the ventricular function as close as possible to normal, and the prevention of infarcted area extension. In this context, this review intends to present the actual knowledge of grape pomace’s potential antioxidant and anti-inflammatory activity in ischemic heart disease, knowledge gathered from existing in vitro and in vivo studies focused on this.

Effect of Acute Intake of Fermented Orange Juice on Fasting and Postprandial Glucose Metabolism, Plasma Lipids and Antioxidant Status in Healthy Human

Higher postprandial plasma glucose and lipemia, and oxidative and inflammatory responses, are considered important cardiovascular risk factors. Fermentation of fruits has generated products with high concentrations of bioactive compounds. The aim of this study was to evaluate the potential acute effects that fermented orange juice (FOJ) can exert in healthy humans by modulating postprandial response, and inflammatory/antioxidant status, compared with orange juice (OJ). Nine volunteers were recruited for a randomized, controlled, and crossover study. Participants ingested 500 mL of FOJ. At 4 h post intake, subjects consumed a standardized mixed meal. Blood samples were collected at 0-8 h hours post intake. The subjects repeated the protocol with OJ following a 2-week washout period. Glucose and lipid metabolism, plasma antioxidant capacity (ORAC, FRAP), endogenous antioxidants (albumin, bilirubin, uric acid), C-reactive protein and fibrinogen were measured in plasma samples. There was a trend of a smaller increase in LDL-C after FOJ intake compared with OJ, a significant decrease in apo-B and significant increase in ORAC. The glycemic and triglyceride response of meal was attenuated with FOJ. No differences were obtained in endogenous antioxidants and inflammation status between the treatments. The acute consumption of FOJ could play a protective role against cardiovascular risk factors.

Therapeutic Effects of Punica granatum (Pomegranate): An Updated Review of Clinical Trials

Punica granatum L. belongs to the Punicaceae family which is distributed around the world. Different parts of pomegranate like seed, peel, juice, and leaves are rich in potential bioactive compounds. These plants have found application in traditional medicine such as in treatment of gastrointestinal, cardiovascular, and endocrine diseases, among others. The present review aimed to summarize the current research on the traditional and scientific applications of P. granatum with regard to the phytochemical content and clinical applications that may be useful for future drug development. Information about P. granatum was obtained from local classic herbal literature and electronic databases, such as PubMed, Scopus, and ScienceDirect. Several phytochemical constituents including polyphenolics, flavonoids, anthocyanosides, alkaloids, lignans, and triterpenes have been reported from the plant. Randomized clinical trials have provided evidence as to the pharmacological activities of pomegranate in several diseases including diabetes, cardiovascular disease, oral cavity disorders, endocrine disorders, and cancer. The present review has provided an insight into the traditional applications of the plants, and some of them have been validated by scientific evidence, particularly their applications as treatment of cardiovascular and endocrine diseases.

Chia Sprouts Elicitation with Salicylic Acid and Hydrogen Peroxide to Improve their Phenolic Content, Antioxidant Capacities In Vitro and the Antioxidant Status in Obese Rats

Elicitation is a biotechnological approach to improve phenolic compounds content and antioxidant properties of ready-to-eat functional foods. This study aimed to evaluate the chemical elicitation effects using salicylic acid (SA) and hydrogen peroxide (H₂O₂) in optimized-germination conditions on seedling vigor, phenolic content, and their antioxidant capacities in vitro and serum and urine of Wistar obese rats. Optimized-germination conditions of 26.5 °C and 178 h produced a 64% of germination and a sprout length of 56 mm. Only, the elicitation with H₂O₂ (20 mM) enhanced the germination (75%) and H₂O₂ (10 and 20 mM) the sprout length (69 and 59 mm, respectively). In contrast, both elicitors enhanced phenolic contents, being more significant total phenolic compounds content for SA (1 and 2 mM), up to 65.5-73.5%. SA and H₂O₂ improved total flavonoids content (36.5-64.1%), ABTS (19.3-61.1%), and DPPH capacities (51-86%), depending on SA and H₂O₂ concentration, compared with non-elicited chia sprouts. The QUENCHER antioxidant capacities of elicited chia sprouts increased up to three times more than extracts capacities, principally Q-ABTS, which could be attributed to phenolic bounds to dietary fiber. Rats fed with a high-fat and fructose diet (HFFD) and supplemented with chia sprouts, especially 1-mM SA, improve the obesity-related oxidative stress through an increase of antioxidant capacities, using DPPH and ABTS test, on serum (70-118%) and urine samples (80-116%). These results suggest that chia sprouts elicited with 1-mM SA are a source of antioxidant compounds that can be used to decrease obesity related oxidative stress.

Acute supplementation with grapes in obese subjects did not affect postprandial metabolism: a randomized, double-blind, crossover clinical trial

PURPOSE

The aim of this study was to determine whether grape polyphenols have a "second-meal effect", modulating glucose and lipid elevations in the postprandial period after two successive meals in subjects with obesity.

METHODS

A randomized, double-blind, placebo-controlled, acute clinical trial was conducted. Twenty-five obese subjects (BMI =  ≥ 30 and < 40 kg/m2) were randomly divided into two groups. At an initial visit, blood was collected in a fasting state and the subjects received breakfast and 46 g of either grape powder (equivalent to 252 g fresh grapes) or placebo, both solved in water. Lunch was provided 5 h later and then blood was collected after 0, 30, 60, 120, 180, 240, 300, 330, 360, and 420 min since arrival. Two weeks later, at a second visit, the subjects received the other powder. The following were determined: glucose, insulin, triglycerides, uric acid, blood count, hemoglobin, viscosity, antioxidant capacity, and satiety perception.

RESULTS

Postprandial increases were observed as expected in, for example, glucose and triglycerides after breakfast and lunch. The grape powder supplementation did not cause any significant modification compared to placebo, in these parameters; nor did it significantly modify plasma antioxidant capacity in the 6 h postprandial period.

DISCUSSION

Single grape powder supplementation did not modify postprandial responses in obese subjects, probably because the polyphenol dose was insufficient to induce such an effect. The result of a combination of grape with other polyphenol-rich products or chronic supplementation with grape powder on postprandial responses remains to be elucidated.

TRIAL REGISTRATION NUMBER

www.clinicaltrials.gov , NCT03741218.

Ellagic Acid as a Tool to Limit the Diabetes Burden: Updated Evidence

Oxidative stress contributes not only to the pathogenesis of type 2 diabetes (T2D) but also to diabetic vascular complications. It follows that antioxidants might contribute to limiting the diabetes burden. In this review we focus on ellagic acid (EA), a compound that can be obtained upon intestinal hydrolysis of dietary ellagitannins, a family of polyphenols naturally found in several fruits and seeds. There is increasing research on cardiometabolic effects of ellagitannins, EA, and urolithins (EA metabolites). We updated research conducted on these compounds and (I) glucose metabolism; (II) inflammation, oxidation, and glycation; and (III) diabetic complications. We included studies testing EA in isolation, extracts or preparations enriched in EA, or EA-rich foods (mostly pomegranate juice). Animal research on the topic, entirely conducted in murine models, mostly reported glucose-lowering, antioxidant, anti-inflammatory, and anti-glycation effects, along with prevention of micro- and macrovascular diabetic complications. Clinical research is incipient and mostly involved non-randomized and low-powered studies, which confirmed the antioxidant and anti-inflammatory properties of EA-rich foods, but without conclusive results on glucose control. Overall, EA-related compounds might be potential agents to limit the diabetes burden, but well-designed human randomized controlled trials are needed to fill the existing gap between experimental and clinical research.

The Effect of Emulsifying Protein and Addition of Condensed Tannins on n-3 PUFA Enriched Emulsions for Functional Foods

This paper examines the effect of the type of the emulsifying protein (EP) (sodium caseinate (SC) and whey protein isolate (WPI)) on both oil-in-water liquid-like emulsions (Es) and the corresponding cold gelled emulsions (GEs), and also the effect of addition of carob extract rich in condensed tannins (T). The systems, intended as functional food ingredients, were studied in various different respects, including rheological behaviour, in vitro gastrointestinal digestion with determination of the release of non-extractable proanthocyanidins (NEPA) from T, antioxidant activity and lipolysis. EP significantly affects the rheological behaviour of both Es and GEs. T incorporation produced a structural reinforcement of GEs, especially in the case of SC. The digests from Es displayed a higher antioxidant activity than those from GEs. T lipase inhibition was observed only in the formulations with WPI. Our results highlight the importance, in the design of functional foods, of analyzing different variables when incorporating a bioactive compound into a food or emulsion in order to select the better combination for the desired objective, owing to the complex interplay of the various components.

Urine Metabolites and Antioxidant Effect after Oral Intake of Date (Phoenix dactylifera L.) Seeds-Based Products (Powder, Bread and Extract) by Human

A cross-over study was conducted in 16 healthy adult volunteers to describe the urinary excretion of polyphenols from date seeds and investigate the antioxidant effect after consumption of different doses of date seeds powder (DSP), bread (DSB) and extract (DSE). After 12 h of fasting, one of the six treatments (0.25 g and 0.5 g/kg bodyweight DSP, 360 g of 10% and 15% DSB, 30 mg and 60 mg/kg bodyweight DSE) was provided along with breakfast, with a two weeks wash-out period between 2 consecutive treatments. Blood was drawn at baseline, 1, 2, 8 and 24 h post intake. Urine was collected at baseline, 3, 8, and 24 h post intake. An abundant release of polyphenols was detected in urine within the 0-3 h post intake, reached a peak at 8 h, then decreased with polyphenols still being detected up to 24 h post intake. The antioxidant defence system, as measured by reduced glutathione (GSH), was strengthened as soon as 1 h and up to 8 h post intake. Markers of protein and lipid oxidative damages were reduced from 1 h and up to 8 and 24 h post intake, respectively. This supports an antioxidant effect of date seeds products in humans, most probably due to their polyphenols.