Allium vegetable intakes and the incidence of cardiovascular disease, hypertension, chronic kidney disease, and type 2 diabetes in adults: a longitudinal follow-up study. J Hypertens. 2017;35:1909-1916. [PMID: 28319598 DOI: 10.1097/hjh.0000000000001356]

Effects of dietary Allium mongolicum Regel powder supplementation on the growth performance, meat quality, antioxidant capacity and muscle fibre characteristics of fattening Angus calves under heat stress conditions

The aim of this study was to investigate the effects of dietary Allium mongolicum Regel powder (AMRP) supplementation on the growth performance, meat quality, antioxidant capacity and muscle fibre characteristics of fattening Angus calves. Growth performance data and longissimus thoracis (LT) samples were collected from four groups of fattening Angus, which were fed either a basal diet (CON) or a basal diet supplemented with an AMRP dose of 10 (LAMR), 15 (MAMR), or 20 g/animal/day AMRP (HAMR) for 120 days before slaughter. AMRP addition to the feed improved growth performance and meat quality and altered muscle fibre type. Some responses to AMRP supplementation were dose dependent, whereas others were not. Together, the results of this study demonstrated that dietary supplementation with 10 g/animal/day AMRP was the optimal dose in terms of fattening calf growth performance, while 20 g/animal/day AMRP supplementation was the optimal dose in terms of meat quality.

Using the concept of food as medicine to mitigate inflammation in patients undergoing peritoneal dialysis

The most common kidney replacement therapy (KRT) worldwide is hemodialysis (HD), and only 5%-10% of patients are prescribed peritoneal dialysis (PD) as KRT. Despite PD being a different method, these patients also present particular complications, such as oxidative stress, gut dysbiosis, premature aging, and mitochondrial dysfunction, leading to an inflammation process and high cardiovascular mortality risk. Although recent studies have reported nutritional strategies in patients undergoing HD with attempts to mitigate these complications, more information must be needed for PD patients. Therefore, this review provides a comprehensive analysis of recent studies of nutritional intervention to mitigate inflammation in PD patients.

Low-carbohydrate dietary score and the incidence of metabolically unhealthy phenotype based on BMI status: a cohort study

There is scarce research focusing on the relationship between the low-carbohydrate dietary score and the development of a metabolically unhealthy phenotype. Therefore, this cohort study was designed to assess the association between the low-carbohydrate dietary score and the risk of metabolically unhealthy phenotypes (MUP). This study included 1299 adults with healthy metabolic profiles who were followed for 5.9 years. Results indicated an inverse association between the second tertile of the low-carbohydrate dietary score and the risk of developing metabolically unhealthy obesity (MUO) (HR: 0.76, 95% CI: 0.59-0.98). In addition, we found an inverse association between the healthy low-carbohydrate dietary score and the risk of MUO (HR: 0.77, 95% CI: 0.60-0.99). Our results revealed a nonlinear inverse association between the low-carbohydrate dietary score and the risk of MUP only in subjects with overweight or obesity. This relationship was independent of animal protein and fat intake. Also, we found that a lower intake of unhealthy carbohydrates was associated with a lower risk of MUP only in subjects with overweight or obesity.

Association between dietary patterns and chronic kidney disease combined with hyperuricemia

Background and aims: Chronic kidney disease (CKD) combined with hyperuricemia is a concerning health issue, but the association between this condition and dietary patterns remains poorly understood. The aim of this study was to assess the associations between dietary patterns and CKD combined with hyperuricemia. Methods: This cross-sectional study was conducted involving 12 318 participants aged 18-79 years during 2018-2020. Dietary intake information was collected using a validated 110-item food frequency questionnaire. Factor analysis was used to identify major dietary patterns. CKD was defined as the presence of albuminuria or an estimated glomerular filtration rate <60 mL min-1 1.73 m-2. Hyperuricemia was defined as serum uric acid levels >420 μmol L-1 both in men and women. Logistic regression models were applied to assess the association between dietary patterns and the risk of CKD combined with hyperuricemia. Results: Five major dietary patterns were identified: 'healthy pattern', 'traditional pattern', 'animal foods pattern', 'sweet foods pattern', and 'tea-alcohol pattern', which together explained 38.93% of the variance in the diet. After adjusting for potential confounders, participants in the highest quartile of the traditional pattern had a lower risk of CKD combined with hyperuricemia (OR = 0.49, 95% CI: 0.32-0.74, Pfor trend < 0.01). Conversely, participants in the highest quartile of the sweet foods pattern had a higher risk compared to those in the lowest quartile (OR = 1.69, 95% CI: 1.18-2.42, Pfor trend < 0.01). However, no significant association was observed between the healthy pattern, animal foods pattern and tea-alcohol pattern and the risk of CKD combined with hyperuricemia. Conclusions: Our results suggest that the traditional pattern is associated with a reduced risk of CKD combined with hyperuricemia, whereas the sweet foods pattern is associated with an increased risk.

Dietary fruits and vegetables and risk of cardiovascular diseases in elderly Chinese

BACKGROUND

Evidence regarding the potential effect of fruit and vegetable consumption on cardiovascular diseases (CVD) was limited and inconsistent among Asian people.

METHODS

We prospectively examined associations of fruit and vegetable consumption with the risk of CVD among 9740 participants aged 65 years and older (mean baseline age: 88 years) in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2008-2018). Dietary data were collected using a validated food frequency questionnaire.

RESULTS

During 37 366 person-years of follow-up, a total of 3738 CVD cases were recorded. After adjusting for demographics, dietary, lifestyle and economical social factors, higher intakes of total fruits and vegetables were associated with lower risk of CVD [comparing with extreme quintiles, hazard ratio and 95% confidence interval: 0.84 (0.74, 0.95)]. The inverse association was mainly driven by vegetable consumption [0.86 (0.77, 0.95)]. Furthermore, the inverse association was stronger for the risk of hypertension [0.84 (0.72, 0.98)]. These associations were consistent across age, sex, body mass index, residence, exercise status, smoking, drinking, meat intake, modified hPDI and health status.

CONCLUSIONS

This study suggests higher intakes of total fruits and vegetables are associated with a lower risk of CVD among elderly Chinese people, supporting the current recommendations of increasing fruit and vegetable consumption as part of a healthy diet for the prevention of CVD.

Fruit and vegetable consumption and the risk of hypertension: a systematic review and meta-analysis of prospective studies

PURPOSE

A high fruit and vegetable intake has been associated with reduced risk of hypertension; however, results have been inconsistent and it is unclear whether specific types of fruits and vegetables are particularly beneficial. This systematic review and meta-analysis aimed to summarize the published prospective studies on fruit and vegetable consumption and risk of hypertension.

METHODS

Embase and PubMed databases were searched for relevant prospective studies up to 15th May 2022. Random effects models were used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for the association between fruit and vegetable intake and risk of hypertension. Strength of evidence was assessed using World Cancer Research Fund (WCRF) criteria.

RESULTS

Eighteen prospective studies (451 291 participants, 145 492 cases) were included. The summary RR (95% CI) of hypertension per 200 g/day was 0.97 (0.95-0.99, I² = 68%, n = 8) for fruits and vegetables, 0.93 (0.89-0.98, I² = 77%, n = 10) for fruits, and 1.00 (0.98-1.02, I² = 38%, n = 10) for vegetables. Reductions in risk were observed up to 800 g/day for fruits and vegetables, and 550 g/day for fruits, and these two associations were considered probably causal using WCRF criteria. Inverse associations were observed for apples or pears, blueberries, raisins or grapes, avocado, broccoli, carrots and lettuce, while positive associations were observed for cantaloupe, Brussels sprouts, cruciferous vegetables, and total and fried potatoes (n = 2-5).

CONCLUSION

A high intake of fruit and vegetables combined, and total fruit was associated with reduced risk of hypertension, while results for fruit and vegetable subtypes were mixed and need further study.

Potential Role of Quercetin Glycosides as Anti-Atherosclerotic Food-Derived Factors for Human Health

Quercetin is a monomeric polyphenol of plant origin that belongs to the flavonol-type flavonoid subclass. Extensive studies using cultured cells and experimental model animals have demonstrated the anti-atherosclerotic effects of dietary quercetin in relation to the prevention of cardiovascular disease (CVD). As quercetin is exclusively present in plant-based foods in the form of glycosides, this review focuses on the bioavailability and bioefficacy of quercetin glycosides in relation to vascular health effects. Some glucose-bound glycosides are absorbed from the small intestine after glucuronide/sulfate conjugation. Both conjugated metabolites and deconjugated quercetin aglycones formed by plasma β-glucuronidase activity act as food-derived anti-atherogenic factors by exerting antioxidant, anti-inflammatory, and plasma low-density lipoprotein cholesterol-lowering effects. However, most quercetin glycosides reach the large intestine, where they are subject to gut microbiota-dependent catabolism resulting in deglycosylated aglycone and chain-scission products. These catabolites also affect vascular health after transfer into the circulation. Furthermore, quercetin glycosides may improve gut microbiota profiles. A variety of human cohort studies and intervention studies support the idea that the intake of quercetin glycoside-rich plant foods such as onion helps to prevent CVD. Thus, quercetin glycoside-rich foods offer potential benefits in terms of cardiovascular health and possible clinical applications.

Consumption of oil macerated with garlic produces renovascular protective effects in adult apolipoprotein E-deficient mice

Oxidative stress and chronic inflammatory conditions contribute as key determinants in the development of vascular and renal diseases. Organosulfur compounds (OSCs) of oil macerated with garlic (OMG) are promising phytochemicals which could protect us from hyper-inflammation and oxidative stress-induced organ damage. The present work evaluated the effect of OMG intake in apolipoprotein E-knockout (ApoE-KO) mice. Adult female ApoE-KO mice were randomly divided into three groups and fed with control chow, oil-supplemented diet and OMG-supplemented diet. After 8 weeks, the animals were euthanized and blood, aorta, kidneys, liver and abdominal adipose tissues were obtained for further analysis. Biochemical parameters were measured in plasma, lipid peroxidation as malondialdehyde (MDA) levels was determined in the adipose tissue, oil red O was used to stain atherosclerotic lesions, and histological and ultrastructural analyses of the kidneys were performed. Renal expression levels of Tumor Necrosis Factor α (TNF-α), Interleukin-6 (IL-6) and Wilms' Tumor Protein (WT-1) were determined by western blotting and the co-immunoprecipitation assay (p53/WT-1). Also, transmission electron microscopy for studying the expression of mitofusin 2 (Mfn-2) was used to assess mitochondrial damage. The results showed that long-term moderate intake of OMG improved serum triglyceride levels, diminished the atheroma plaque area, and reduced lipid peroxidation. Furthermore, we found a decrease in oxidative and inflammatory markers, less apoptosis and reduced WT-1 expression in the kidneys. Also, OMG increased p53/WT-1 protein interactions and reduced mitochondrial damage. Our findings suggest that OMG intake would produce anti-atherosclerotic, antifibrotic, anti-inflammatory and antiapoptotic effects in adult ApoE-KO mice, conferring significant renovascular protective actions in a mechanism mediated, at least in part, by WT-1.

Natural Products in Cardiovascular Diseases: The Potential of Plants from the Allioideae Subfamily (Ex-Alliaceae Family) and Their Sulphur-Containing Compounds

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide and, together with associated risk factors such as diabetes, hypertension, and dyslipidaemia, greatly impact patients' quality of life and health care systems. This burden can be alleviated by fomenting lifestyle modifications and/or resorting to pharmacological approaches. However, due to several side effects, current therapies show low patient compliance, thus compromising their efficacy and enforcing the need to develop more amenable preventive/therapeutic strategies. In this scenario, medicinal and aromatic plants are a potential source of new effective agents. Specifically, plants from the Allioideae subfamily (formerly Alliaceae family), particularly those from the genus Allium and Tulbaghia, have been extensively used in traditional medicine for the management of several CVDs and associated risk factors, mainly due to the presence of sulphur-containing compounds. Bearing in mind this potential, the present review aims to gather information on traditional uses ascribed to these genera and provide an updated compilation of in vitro and in vivo studies validating these claims as well as clinical trials carried out in the context of CVDs. Furthermore, the effect of isolated sulphur-containing compounds is presented, and whenever possible, the relation between composition and activity and the mechanisms underlying the beneficial effects are pointed out.

Effects of colonic fermentation on the stability of fresh and black onion bioactives

The health properties related to onion intake are attributed mainly to the presence of bioactive compounds, particularly phenolic and organosulfur compounds (OSCs). The aim of this study was to investigate, for the first time, the effect of an in vitro colonic fermentation on the stability of phenolic and OSCs of fresh and black onion by ultra-high-performance liquid chromatography coupled with mass spectrometry with a linear ion trap (UHPLC-LIT-MS). Throughout colonic fermentation, fresh onion showed an increase in the total phenolic content of 45%, mainly due to an increase in the content of the flavonoid family, while the OSCs remained stable along the fermentation. Black onion presented a different behaviour, showing significant decreases in total (poly)phenol and OSC content, 22 and 48%, respectively. The main compounds found after the in vitro colonic fermentation of fresh onion were isorhamnetin (141 μmol L^-1), quercetin (95 μmol L^-1), 3,4-dihydroxybenzoic acid (53 μmol L^-1), methionine sulfoxide (100 μmol L^-1) and S-allylcysteine (SAC) (21.7 μmol L^-1), whereas 3,4-dihydroxybenzoic acid (70 μmol L^-1), 4-hydroxyphenylacetic acid (68 μmol L^-1), methionine sulfoxide (82 μmol L^-1) and S-propylmercapto-L-cysteine (SPMC) (10.1 μmol L^-1) accounted for the highest concentrations of phenolics and OSCs in fermented black onion. These compounds, presumably present for their absorption and action at the colonic level, could be related to the health benefits of regular consumption of fresh and black onion.

Variations in Total Phenolic, Total Flavonoid Contents, and Free Radicals' Scavenging Potential of Onion Varieties Planted under Diverse Environmental Conditions

Genetic diversity and Agro-climatic conditions contribute significantly to the agronomic and morphological features of the food plant species, and their nutraceutical potential. The present study was intended to evaluate the impact of growing conditions on total phenolic and total flavonoid contents, and in vitro antioxidant potential in the bulbs and leaves of onion varieties planted under diverse environmental conditions. Standard analytical methods were used to quantify total phenolic content (TPC), total flavonoid content (TFC), and free radicals’ scavenging/antioxidant capacity. The impact of climatic and soil conditions was assessed using statistical tools. In general, onion varieties cultivated at three different locations viz. Kalar Kahar, Lahore and Swabi exhibited significant variations in TPC and TFC, and antioxidant activities. The bulbs and leaves of Mustang (V1) variety planted at Lahore and Swabi had significantly (p < 0.05), high levels of TPC (659.5 ± 6.59, and 631.1 ± 8.58 mg GAE/100 g, respectively). However, leaves of Red Orb (V2) and bulbs of Mustang (V1), and Golden Orb (V6), harvested from Kalar Kahar depicted the highest concentration of TFC (432.5 ± 10.3, 303.0 ± 6.67, and 303.0 ± 2.52 mg QE/100 g DW, respectively). Likewise, bulbs of V1 planted at Kalar Kahar, Lahore and Swabi exhibited maximum inhibition of DPPH, ABTS, and H2O2 radicals (79.01 ± 1.49, 65.38 ± 0.99, and 59.76 ± 0.90%, respectively). Golden Orb (V6) harvested from Lahore had the highest scavenging of OH radical (67.40 ± 0.09%). Likewise, bulbs of V1 variety planted at KalarKahar and Swabi had significant capacity to scavenge ferric ions (415.1 ± 10.6 mg GAE/100 g DW), and molybdate ions (213.7 ± 0.00 mg AAE/100 g DW). Conversely, leaves of Amazon (V8), planted at Lahore and Swabi depicted significant levels of DPPH, ABTS, H2O2 radical scavenging (90.69 ± 0.26, 63.55 ± 1.06, 51.86 ± 0.43%, respectively), and reduction of ferric ions (184.2 ± 6.75 mg GAE/100 g DW). V6 leaves harvested from Lahore and that of Super Sarhad (V3) from Swabi showed the highest inhibition of OH radical (61.21 ± 0.79%), and molybdate ions (623.6 ± 0.12 mg AAE/100 g DW), respectively. Pearson correlation and principal component analysis revealed strong relationships of climatic conditions, soil properties and elevation with TPC, TFC and free radicals’ scavenging potential in the bulbs and leaves of onion varieties. The variations in the total phenolic and flavonoid contents, and antioxidant potential of different varieties, and their associations with climatic and soil factors revealed the complexity of the growing conditions and genetic makeup that imposed significant impacts on the synthesis of secondary metabolites and nutraceutical potential of food and medicinal plant species.

Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective studies

BACKGROUND

The association between intake of fruit and vegetables and their subtypes, and the risk of type 2 diabetes has been investigated in several studies, but the results have been inconsistent.

OBJECTIVE

We conducted an updated systematic review and dose-response meta-analysis of prospective studies on intakes of fruit and vegetables and fruit and vegetable subtypes and the risk of type 2 diabetes.

DESIGN

PubMed and Embase databases were searched up to 20 October 2020. Prospective cohort studies of fruit and vegetable consumption and type 2 diabetes mellitus were included. Summary relative risks (RRs) and 95% CIs were estimated using a random effects model.

RESULTS

We included 23 cohort studies. The summary RR for high versus low intake and per 200 g/day were 0.93 (95% CI: 0.89 to 0.98, I²=0%, n=10 studies) and 0.98 (95% CI: 0.95 to 1.01, I²=37.8%, n=7) for fruit and vegetables combined, 0.93 (95% CI: 0.90 to 0.97, I²=9.3%, n=20) and 0.96 (95% CI: 0.92 to 1.00, I²=68.4%, n=19) for fruits and 0.95 (95% CI: 0.88 to 1.02, I²=60.4%, n=17) and 0.97 (95% CI: 0.94 to 1.01, I²=39.2%, n=16) for vegetables, respectively. Inverse associations were observed for apples, apples and pears, blueberries, grapefruit and grapes and raisins, while positive associations were observed for intakes of cantaloupe, fruit drinks, fruit juice, brussels sprouts, cauliflower and potatoes, however, most of these associations were based on few studies and need further investigation in additional studies.

CONCLUSIONS

This meta-analysis found a weak inverse association between fruit and vegetable intake and type 2 diabetes risk. There is indication of both inverse and positive associations between intake of several fruit and vegetables subtypes and type 2 diabetes risk, however, further studies are needed before firm conclusions can be made.

Dietary Organosulfur-Containing Compounds and Their Health-Promotion Mechanisms

Dietary organosulfur-containing compounds (DOSCs) in fruits, vegetables, and edible mushrooms may hold the key to the health-promotion benefits of these foods. Yet their action mechanisms are not clear, partially due to their high reactivity, which leads to the formation of complex compounds during postharvest processing. Among postharvest processing methods, thermal treatment is the most common way to process these edible plants rich in DOSCs, which undergo complex degradation pathways with the generation of numerous derivatives over a short time. At low temperatures, DOSCs are biotransformed slowly during fermentation to different metabolites (e.g., thiols, sulfides, peptides), whose distinctive biological activity remains largely unexplored. In this review, we discuss the bioavailability of DOSCs in human digestion before illustrating their potential mechanisms for health promotion related to cardiovascular health, cancer chemoprevention, and anti-inflammatory and antimicrobial activities. In particular, it is interesting that different DOSCs react with glutathione or cysteine, leading to the slow release of hydrogen sulfide (H2S), which has broad bioactivity in chronic disease prevention. In addition, DOSCs may interact with protein thiol groups of different protein targets of importance related to inflammation and phase II enzyme upregulation, among other action pathways critical for health promotion.

Expected final online publication date for the Annual Review of Food Science and Technology, Volume 13 is March 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

In vitro and in vivo antihypertensive and antioxidant activities of fermented roots of Allium hookeri

Objective

To evaluate antihypertensive and antioxidant activities of Allium hookeri root (AHR) fermented with Lactobacillus plantarum, Leuconostoc mesenteroides, and Weissella cibaria.

Methods

The novel fermented AHR products using L. plantarum, L. mesenteroides, and W. cibaria were developed and ACE inhibitory activity, DPPH radical scavenging activity, hydroxyl radical scavenging activity, superoxide anion radical scavenging activity, total phenolic content, and total thiosulfinate content were determined. The antihypertensive and antioxidant effects of fermented AHR were further investigated in spontaneously hypertensive rats (SHRs).

Results

Administration of fermented AHR to SHRs had an attenuating effect on both diastolic and systolic blood pressure. The SHRs treated with fermented AHR showed lower plasma ACE activity and higher plasma NO levels. Furthermore, fermented AHR administration led to parallel improvements in plasma oxidative stress biomarkers in SHRs.

Conclusion

Our results highlight the potential usefulness of fermented AHR for the prevention of hypertension.

Diet and Hydrogen Sulfide Production in Mammals

Significance: In recent times, it has emerged that some dietary sulfur compounds can act on mammalian cell signaling systems via their propensity to release hydrogen sulfide (H₂S). H₂S plays important biochemical and physiological roles in the heart, gastrointestinal tract, brain, kidney, and immune systems of mammals. Reduced levels of H₂S in cells and tissues correlate with a spectrum of pathophysiological conditions, including heart disease, diabetes, obesity, and altered immune function. Recent Advances: In the last decade, researchers have now begun to explore the mechanisms by which dietary-derived sulfur compounds, in addition to cysteine, can act as sources of H₂S. This research has led to the identified several compounds, organic sulfides, isothiocyanates, and inorganic sulfur species including sulfate that can act as potential sources of H₂S in mammalian cells and tissues. Critical Issues: We have summarised progress made in the identification of dietary factors that can impact on endogenous H₂S levels in mammals. We also describe current research focused on how some sulfur molecules present in dietary plants, and associated chemical analogues, act as sources of H₂S, and discuss the biological properties of these molecules as studied in a range of in vitro and in vivo systems. Future Directions: The identification of sulfur compounds in edible plants that can act as novel H₂S releasing molecules is intriguing. Research in this area could inform future studies exploring the impact of diet on H₂S levels in mammalian systems. Despite recent progress, additional work is needed to determine the mechanisms by which H₂S is released from these molecules following ingestions of dietary plants in humans, whether the amounts of H₂S produced is of physiological significance following the metabolism of these compounds in vivo, and if diet could be used to manipulated H₂S levels in humans. Importantly, this will lead to a better understanding of the biological significance of H₂S generated from dietary sources, and this information could be used in the development of plant breeding initiatives to increase the levels of H₂S releasing sulfur compounds in crops, or inform dietary intervention strategies that could be used to alter the levels of H₂S in humans.

Influence of Cooking Methods on Onion Phenolic Compounds Bioaccessibility

The impact of domestic cooking (baking, boiling, frying and grilling) and in vitro digestion on the stability and release of phenolic compounds from yellow-skinned (YSO) and red-skinned onions (RSO) have been evaluated. The mass spectrometry identification pointed out flavonols as the most representative phenolic class, led by quercetin-derivatives. RSO contained almost the double amount of phenolic compounds respect to YSO (50.12 and 27.42 mg/100 g, respectively). Baking, grilling and primarily frying resulted in an increased amount of total phenolic compounds, especially quercetin-derivatives, in both the onion varieties. Some treatments promoted the degradation of quercetin-3-O-hexoside-4′-O-hexoside, the main compound present in both the onion varieties, leading to the occurrence of quercetin-4′-O-hexoside and protocatechuic acid-4-O-hexoside. After in vitro digestion, the bioaccessibility index for total phenolic compounds ranged between 42.6% and 65.5% in grilled and baked YSO, respectively, and between 39.8% and 80.2% in boiled and baked RSO, respectively. Baking contributed to the highest amount of bioaccessible phenolic compounds for both the onion varieties after in vitro digestion. An in-depth design of the cooking process may be of paramount importance in modulating the gastro-intestinal release of onion phenolic compounds.

Trends in H2S-Donors Chemistry and Their Effects in Cardiovascular Diseases

Hydrogen sulfide (H₂S) is an endogenous gasotransmitter recently emerged as an important regulatory mediator of numerous human cell functions in health and in disease. In fact, much evidence has suggested that hydrogen sulfide plays a significant role in many physio-pathological processes, such as inflammation, oxidation, neurophysiology, ion channels regulation, cardiovascular protection, endocrine regulation, and tumor progression. Considering the plethora of physiological effects of this gasotransmitter, the protective role of H₂S donors in different disease models has been extensively studied. Based on the growing interest in H₂S-releasing compounds and their importance as tools for biological and pharmacological studies, this review is an exploration of currently available H₂S donors, classifying them by the H₂S-releasing-triggered mechanism and highlighting those potentially useful as promising drugs in the treatment of cardiovascular diseases.

From the distinctive smell to therapeutic effects: Garlic for cardiovascular, hepatic, gut, diabetes and chronic kidney disease

Garlic, a member of the Allium family, widely used in cooking for many centuries, displays well described antioxidant and anti-inflammatory properties, as a result of its constituent organosulfur compounds, such as alliin, allicin, ajoene S-allyl-cysteine, diallyl sulfide and diallyl disulfide, among others. Although garlic has demonstrated beneficial effects in cardiovascular disease, diabetes, and cancer, its efficacy as a therapeutic intervention in chronic kidney disease remains to be proven. This review thus focuses on the potential benefits of garlic as a treatment option in chronic kidney disease. and its ability to mitigate associated cardiovascular complications and gut dysbiosis.

Nutritional Values of Onion Bulbs with Some Essential Structural Parameters for Packaging Process

Onions belong to the Allium genus that has been frequently used for human diet and the traditional medication due to the bioactive compounds. The main nutritional values, vitamins, and amino acid compositions of onion bulbs (Yellow, Red, Green, Leek, and Baby onions) with some essential structural parameters for the packaging process were investigated. Physical and structural parameters with frictions were applied for the packaging process. The results reported that moisture content was the main component of onion bulbs (88.65%). Besides, they were rich in proteins (9.22–13.21 g/100 g infresh weight) (FW). Results reported that Red and Yellow varieties established the largest vitamin C and carotenoids contents (45.07 mg/100 g−1 FW) and (1.44 µg/mL FW), respectively. The major amino acid was arginine which was highly found in Green variety (17.02 mg/g FW) and a relatively high amount of glutamic and aspartic acids as (9.88–14.89 mg/g FW) and (4.93–10.55 mg/g FW), respectively. Yellow variety established the largest width, thickness, surface area, aspect ratio, and sphericity. The highest static and kinetic frictions were established on steel (0.14–0.52) and (0.75–0.96), respectively. This study presents the nutritional evidence of onion varieties for the human diet besides the horticultural processing for packaging quality improvement.

Antioxidant Food Components for the Prevention and Treatment of Cardiovascular Diseases: Effects, Mechanisms, and Clinical Studies

Cardiovascular diseases (CVDs) have gained increasing attention because of their high prevalence and mortality worldwide. Epidemiological studies revealed that intake of fruits, vegetables, nuts, and cereals could reduce the risk of CVDs, and their antioxidants are considered as the main contributors. Moreover, experimental studies showed that some antioxidant natural products and their bioactive compounds exerted beneficial effects on the cardiovascular system, such as polyphenols, polysaccharides, anthocyanins, epigallocatechin gallate, quercetin, rutin, and puerarin. The mechanisms of action mainly included reducing blood pressure, improving lipid profile, ameliorating oxidative stress, mitigating inflammation, and regulating gut microbiota. Furthermore, clinical trials confirmed the cardiovascular-protective effect of some antioxidant natural products, such as soursop, beetroot, garlic, almond, and green tea. In this review, we summarized the effects of some antioxidant natural products and their bioactive compounds on CVDs based on the epidemiological, experimental, and clinical studies, with special attention paid to the relevant mechanisms and clinical trials.

Modifiable Lifestyle Factors for Primary Prevention of CKD: A Systematic Review and Meta-Analysis

BACKGROUND

Despite increasing incidence of CKD, no evidence-based lifestyle recommendations for CKD primary prevention apparently exist.

METHODS

To evaluate the consistency of evidence associating modifiable lifestyle factors and CKD incidence, we searched MEDLINE, Embase, CINAHL, and references from eligible studies from database inception through June 2019. We included cohort studies of adults without CKD at baseline that reported lifestyle exposures (diet, physical activity, alcohol consumption, and tobacco smoking). The primary outcome was incident CKD (eGFR<60 ml/min per 1.73 m²). Secondary outcomes included other CKD surrogate measures (RRT, GFR decline, and albuminuria).

RESULTS

We identified 104 studies of 2,755,719 participants with generally a low risk of bias. Higher dietary potassium intake associated with significantly decreased odds of CKD (odds ratio [OR], 0.78; 95% confidence interval [95% CI], 0.65 to 0.94), as did higher vegetable intake (OR, 0.79; 95% CI, 0.70 to 0.90); higher salt intake associated with significantly increased odds of CKD (OR, 1.21; 95% CI, 1.06 to 1.38). Being physically active versus sedentary associated with lower odds of CKD (OR, 0.82; 95% CI, 0.69 to 0.98). Current and former smokers had significantly increased odds of CKD compared with never smokers (OR, 1.18; 95% CI, 1.10 to 1.27). Compared with no consumption, moderate consumption of alcohol associated with reduced risk of CKD (relative risk, 0.86; 95% CI, 0.79 to 0.93). These associations were consistent, but evidence was predominantly of low to very low certainty. Results for secondary outcomes were consistent with the primary finding.

CONCLUSIONS

These findings identify modifiable lifestyle factors that consistently predict the incidence of CKD in the community and may inform both public health recommendations and clinical practice.

Relation of Different Fruit and Vegetable Sources With Incident Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Background Public health policies reflect concerns that certain fruit sources may not have the intended benefits and that vegetables should be preferred to fruit. We assessed the relation of fruit and vegetable sources with cardiovascular outcomes using a systematic review and meta-analysis of prospective cohort studies. Methods and Results MEDLINE, EMBASE, and Cochrane were searched through June 3, 2019. Two independent reviewers extracted data and assessed study quality (Newcastle-Ottawa Scale). Data were pooled (fixed effects), and heterogeneity (Cochrane-Q and I2) and certainty of the evidence (Grading of Recommendations Assessment, Development, and Evaluation) were assessed. Eighty-one cohorts involving 4 031 896 individuals and 125 112 cardiovascular events were included. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (risk ratio, 0.93 [95% CI, 0.89-0.96]; 0.91 [0.88-0.95]; and 0.94 [0.90-0.97], respectively), coronary heart disease (0.88 [0.83-0.92]; 0.88 [0.84-0.92]; and 0.92 [0.87-0.96], respectively), and stroke (0.82 [0.77-0.88], 0.82 [0.79-0.85]; and 0.88 [0.83-0.93], respectively) incidence. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (0.89 [0.85-0.93]; 0.88 [0.86-0.91]; and 0.87 [0.85-0.90], respectively), coronary heart disease (0.81 [0.72-0.92]; 0.86 [0.82-0.90]; and 0.86 [0.83-0.89], respectively), and stroke (0.73 [0.65-0.81]; 0.87 [0.84-0.91]; and 0.94 [0.90-0.99], respectively) mortality. There were greater benefits for citrus, 100% fruit juice, and pommes among fruit sources and allium, carrots, cruciferous, and green leafy among vegetable sources. No sources showed an adverse association. The certainty of the evidence was "very low" to "moderate," with the highest for total fruit and/or vegetables, pommes fruit, and green leafy vegetables. Conclusions Fruits and vegetables are associated with cardiovascular benefit, with some sources associated with greater benefit and none showing an adverse association. Registration URL: https://www.clini​caltr​ials.gov; Unique identifier: NCT03394339.

Diet and Kidney Function: a Literature Review

PURPOSE OF REVIEW

The burden of chronic kidney disease (CKD) is increasing worldwide. For CKD prevention, it is important to gain insight in commonly consumed foods and beverages in relation to kidney function.

RECENT FINDINGS

We included 21 papers of prospective cohort studies with 3-24 years of follow-up. We focused on meat, fish, dairy, vegetables, fruit, coffee, tea, soft drinks, and dietary patterns. There was convincing evidence that a healthy dietary pattern may lower CKD risk. Plant-based foods, coffee, and dairy may be beneficial. Unhealthy diets and their components, such as red (processed) meat and sugar-sweetened beverages, may promote kidney function loss. For other foods and beverages, associations with CKD were neutral and/or the number of studies was too limited to draw conclusions. Healthy dietary patterns are associated with a lower risk of CKD. More research is needed into the effects of specific food groups and beverages on kidney function.

Comparison of Organosulfur and Amino Acid Composition between Triploid Onion Allium cornutum Clementi ex Visiani, 1842, and Common Onion Allium cepa L., and Evidences for Antiproliferative Activity of Their Extracts

Species that belong to the genus Allium have been widely used for human food and traditional medicine. Their beneficial health effects, as well as the specific aroma, are associated with their bioactive chemical compounds, such as sulfur compounds and flavonoids. Gas chromatography and mass spectrometry (GC-MS) and reverse-phase high-performance liquid chromatography (reverse-phase HPLC) were used to identify organosulfur and amino acid content of triploid hybrid onion, Allium cornutum Clement ex Visiani, 1842, and common onion, Allium cepa L. Allium extracts were tested for their antiproliferative activity in three human cancer cell lines (HeLa, HCT116, and U2OS). DNA fragmentation and DAPI staining analysis were performed on HeLa cells to evaluate the effect of extracts on DNA damage and cell morphology. The mRNA expression of p53, Bax, and Caspase-3 genes involved in apoptosis were analyzed by real-time PCR. Using GC-MS, 27 compounds were found in two Allium species headspaces. Differences were noted among the main compound abundance in the headspace (although the major thiols and disulfides were qualitatively identic in both Allium species) and dipropyl disulfide, diisopropyl trisulfide, and (Z)-prop-1-enyl propyl trisulfide were predominant sulfides. Identification of amino acids and their quantities were determined by reverse-phase HPLC. Most abundant amino acids in both onions were arginine (Arg) and glutamic acid (Glu). The results of cytotoxicity testing confirmed antiproliferative effects of both species. The DNA fragmentation assay, DAPI staining and real time PCR analysis confirmed that A. cornutum and A. cepa extracts induced apoptosis in HeLa cells. This study presents the evidence for possible therapeutic use of A. cornutum and A. cepa extracts against human cervical carcinoma cell line.

An Appraisal of Developments in Allium Sulfur Chemistry: Expanding the Pharmacopeia of Garlic

Alliums and allied plant species are rich sources of sulfur compounds that have effects on vascular homeostasis and the control of metabolic systems linked to nutrient metabolism in mammals. In view of the multiple biological effects ascribed to these sulfur molecules, researchers are now using these compounds as inspiration for the synthesis and development of novel sulfur-based therapeutics. This research has led to the chemical synthesis and biological assessment of a diverse array of sulfur compounds representative of derivatives of S-alkenyl-l-cysteine sulfoxides, thiosulfinates, ajoene molecules, sulfides, and S-allylcysteine. Many of these synthetic derivatives have potent antimicrobial and anticancer properties when tested in preclinical models of disease. Therefore, the current review provides an overview of advances in the development and biological assessment of synthetic analogs of allium-derived sulfur compounds.

Plant Foods, Antioxidant Biomarkers, and the Risk of Cardiovascular Disease, Cancer, and Mortality: A Review of the Evidence

Although a high intake of plant foods such as fruits, vegetables, whole grains, nuts, and legumes has been recommended for chronic disease prevention, it has been unclear what is the optimal amount of intake of these foods and whether specific subtypes are particularly beneficial. The evidence from several recently published meta-analyses on plant foods and antioxidants and various health outcomes is reviewed as well as more recently published studies. In meta-analyses of prospective studies, inverse associations were observed between intake of fruits, vegetables, whole grains, and nuts and the risk of coronary artery disease, stroke, cardiovascular disease overall, total cancer, and all-cause mortality. The strongest reductions in risk were observed at an intake of 800 g/d for fruits and vegetables, 225 g/d for whole grains, and 15-20 g/d for nuts, respectively. Whole-grain and nut consumption was also inversely associated with mortality from respiratory disease, infections, and diabetes. Stronger and more linear inverse associations were observed between blood concentrations of antioxidants (vitamin C, carotenoids, vitamin E) and cardiovascular disease, cancer, and all-cause mortality than for dietary intake. Most studies that have since been published have been consistent with these results; however, further studies are needed on subtypes of plant foods and less common causes of death. These results strongly support dietary recommendations to increase intake of plant foods, and suggest optimal intakes for chronic disease prevention may be ∼800 g/d for intakes of fruits and vegetables, 225 g/d for whole grains, and 15-20 g/d for nuts. Diets high in plant foods could potentially prevent several million premature deaths each year if adopted globally.

Raw garlic consumption is inversely associated with prehypertension in a large-scale adult population

Previous studies have shown that allicin can lower blood pressure (BP) by reducing oxidative stress and inflammation. However, the association between habitual raw garlic intake (as allicin source) and prehypertension are unclear. The aim of this study was to investigate how raw garlic consumption is associated with prehypertension in an adult population. A cross-sectional study was conducted with 22,812 adults (mean [standard deviation] age: 39.4 [10.7] years; males, 47.7%) in Tianjin, China. Raw garlic consumption was assessed using a validated food frequency questionnaire. BP was measured at least twice by trained nurses using an automatic device. Prehypertension was defined as systolic BP of 120-139 mmHg and/or diastolic BP of 80-89 mmHg without taking antihypertensive medication. Multiple logistic regression models were used to assess the association between raw garlic consumption and prehypertension. The prevalence of prehypertension was 49.9%. After fully adjusting for potential confounders, the ORs (95% confidence intervals) of having prehypertension by increasing frequency of raw garlic consumption were 1.00 (reference) for ≤3 times/week, 0.96 (0.87, 1.06) for 4 times/week to 1 time/day, and 0.69 (0.52, 0.90) for ≥2 times/day (p for trend = 0.06). In contrast, no associations were observed between other kinds of allium vegetables consumption and prehypertension. In conclusion, our results suggested that a more frequent consumption of raw garlic was inversely associated with prehypertension. This is the first large-scale study on the association between raw garlic consumption and prehypertension in the general population.

Prospective study of total and various types of vegetables and the risk of metabolic syndrome among children and adolescents

BACKGROUND

Data available on the association between consumption of various types of vegetables and metabolic syndrome (MetS) remain inconsistent.

AIM

To investigate the association between the intake of various types of vegetables and MetS among children and adolescents and MetS.

METHODS

The Tehran Lipid and Glucose Study cohort included 424 children and adolescents initially free of MetS. At the 3.6 year follow-up, 47 new cases of MetS were identified. A 168-item semi-quantitative food-frequency questionnaire was used to collect information about total and various types of vegetables consumed, including allium-, green leafy-, fruity-, root-, stalk-, starchy-, potatoes, and cabbage. MetS was defined according to the Cook et al^[32] criteria.

RESULTS

The median (interquartile range) of total vegetable consumption was 217 (146-344) g/d. After adjustment for demographic characteristics and dietary intake, higher total- (≥ 350 g/d) and higher allium vegetable consumption (≥ 30 g/d) in the fourth quartile were significantly and inversely associated with risk of MetS compared to the first quartile. Consumption of green leafy vegetables in the third (21.4-38.3 g/d) versus the first quartile (≤ 13.5 g/d) demonstrated a significant inverse association with lower risk of MetS in children and adolescents; associations for other types of vegetables consumed were not significant.

CONCLUSION

Consumption of vegetables, especially allium and green leafy vegetables, in sufficient amounts may be beneficial in reducing the risk of MetS among children and adolescents.

Nutrition and Diabetes, Cardiovascular and Chronic Kidney Diseases: Findings from 20 Years of the Tehran Lipid and Glucose Study

CONTEXT

The high prevalence of chronic diseases can be prevented or managed by specific changes in lifestyle patterns of individuals of which dietary factors is emphasized. The objective of this study was to review all findings of the Tehran Lipid and Glucose Study regarding validity and reliability of food frequency questionnaire (FFQ), evaluating dietary quality and association of dietary factors in relation to diabetes, dysglycemia, cardiovascular (CVD) and chronic kidney disease (CKD).

EVIDENCE ACQUISITION

Related documents were searched through PubMed and Scopus databases, in English language from 2000 to 2017. Finally, 52 relevant documents were eligible for inclusion in this review.

RESULTS

The FFQ proved to be an acceptable tool for assessing nutrient and food group intakes and rank individuals accurately according to the levels of their dietary intakes. After 8 years of follow-up, the western dietary pattern (DP) was fairly stable but there was instability of traditional Iranian DP. DPs of over two-thirds of Tehranian populations were not in accordance with the dietary recommendations. Higher dietary scores of variety and healthy DPs were also associated with reduced odds of dysglycemia. The main dietary factor related to increased risk of CVD in our population was western DP. Patterns of amino acid intakes may contribute to the development of CVD. Higher intakes of several micronutrients and macronutrients, DPs and some vegetables decrease the risk of CKD. In conclusion DPs of most Tehranian adults need improvement.

CONCLUSIONS

This review showed that higher adherence to healthy food choices was associated with reduced odds of dysglycemia and CVD. Dietary sources of renal-protective nutrients should be encouraged among the general population.

Nutrition and Cardio-Metabolic Risk Factors: Findings from 20 Years of the Tehran Lipid and Glucose Study

CONTEXT

Genetic and environmental factors contribute to the incidence of metabolic syndrome (MetS). This study aimed to review all findings of studies conducted in framework of the Tehran lipid and glucose study (TLGS) regarding the association of dietary factors with cardio-metabolic risk factors.

EVIDENCE ACQUISITION

All English-language studies were searched using PubMed and Scopus databases from 2000 to 2017. Finally, 105 relevant papers were included in this review.

RESULTS

Whole grains, legumes, nuts and healthy dietary patterns (DPs) reduced risk of MetS, while white rice, salty/sweet snacks increased this. The western DP had a significant interaction with APOC3, APOA1 and MC4R polymorphisms in relation to MetS. After 6.5 years of follow-up, odds of reaching menarche ≤ 12 years was significantly higher in girls with higher intakes of milk, calcium, magnesium, and phosphorous. Among children and adolescents, higher adherence to the dietary approaches to stop hypertension (DASH)-style diet decreased the risk of abdominal obesity, whereas increased adherence to the western DP could contribute to general and abdominal obesity. A three-year follow-up of adult participants showed that higher intakes of phytochemical-rich foods were inversely related to development of insulin resistance. Higher adherence to the healthy DPs was associated with the reduced risk of hyperlipidemia and hypertention. Nutrition interventions postponed rise in the prevalence of MetS. The DASH diet resulted in weight reduction compared to control diet.

CONCLUSIONS

Higher adherence to healthy food choices was associated with reduced odds of MetS, abdominal obesity, dyslipidemia and hypertension. The western DP accentuated the association of polymorphisms with MetS.

Contributions and Implications of the Tehran Lipid and Glucose Study

Tehran Lipid and Glucose Study (TLGS), an epidemiological study of non-communicable disease with 20 years follow up in a developing country in nutrition transition is a unique study in 15000 family based individuals, 3 - 75 years of age in a part of large city of Tehran. The success rate of recruitment for 20 years, intervention for lifestyle change, and thyroid, reproduction and cardiometabolic genetic studies derived from TLGS have paved suitable path towards precision medicine. In this review, baseline findings and changes of risk factors for the development of NCD including body weight, nutrition, physical activity, blood pressure, tobacco smoking, serum glucose and serum lipids as well as metabolic syndrome, chronic kidney disease, quality of life and biochemical findings in TLGS cohort have been summarized. The results of community based intervention for lifestyle change caused decreases in the prevalence of metabolic syndrome and the incidence of diabetes. It is concluded that TLGS has served as a model for other cohort studies in Iran and the region; it has helped to mobilize scientists in developing countries; it has established locally needed definitions of NCD variables; has served as a model for cohort studies in developing countries in nutrition transition with all socioeconomic constraints and has helped manpower education and development of local CVD risk scores for implementation of NCD management.

Garlic and Gaseous Mediators

Garlic (Allium sativum) and allied plant species are rich sources of sulfur compounds. Major roles for garlic and its sulfur constituents include the regulation of vascular homeostasis and the control of metabolic systems linked to nutrient metabolism. Recent studies have indicated that some of these sulfur compounds, such as diallyl trisulfide (DATS), alter the levels of gaseous signalling molecules including nitric oxide (NO), hydrogen sulfide (H₂S), and perhaps carbon monoxide (CO) in mammalian tissues. These gases are important in cellular processes associated with the cardiovascular system, inflammation, and neurological functions. Importantly, these studies build on the known biological effects of garlic and associated sulfur constituents. This review highlights our current understanding of the health benefits attributed to edible plants like garlic.

Dietary sodium to potassium ratio and the incidence of hypertension and cardiovascular disease: A population-based longitudinal study

OBJECTIVE

There is an interaction between dietary sodium/potassium intake in the pathogenesis of hypertension (HTN) and cardiovascular disease (CVD). The aim of this study was to investigate the association of dietary sodium to potassium (Na/K) ratio and the risk of HTN and CVD in a general population of Iranian adults.

METHODS

In this prospective cohort study, adults men and women with complete baseline data were selected from among participants of the Tehran Lipid and Glucose Study and were followed up for 6.3 years for incidence of HTN and CVD outcomes. Dietary sodium and potassium were assessed using a valid and reliable 168-item food frequency questionnaire. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between dietary sodium, potassium and their ratio and risk of outcomes.

RESULTS

During the study follow-up, 291 (15.1%) and 79 (5.0%) new cases of HTN and CVD were identified, respectively. No significant association was observed between usual intakes of sodium, potassium and dietary Na/K ratio with the incidence of HTN. There was no significant association between dietary intakes of sodium and potassium per se and the risk of CVD, whereas when dietary sodium to potassium ratio was considered as exposure in the fully-adjusted Cox regression model, and participants in the highest compared to lowest tertile had a significantly increased risk of CVD (HR = 2.19, 95% CI = 1.16-4.14).

CONCLUSIONS

Our findings suggest that high dietary Na/K ratio could contribute to increased risk of CVD events.