Effects of Acute Consumption of Noni and Chokeberry Juices vs. Energy Drinks on Blood Pressure, Heart Rate, and Blood Glucose in Young Adults

Acute effects of energy drink consumption on cardiovascular parameters in healthy adults: a systematic review and meta-analysis of randomized clinical trials

CONTEXT

Energy drinks (EDs) are beverages that contain ingredients that may pose a risk to consumers' cardiovascular health. But current evidence is conflicting and warrants further investigation.

OBJECTIVE

A systematic review and meta-analysis was conducted on studies that examined the acute effects of ED consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate, cardiac output (CO), endothelial function, and QT/QTc interval in healthy adults.

DATA SOURCES

The databases PubMed, EMBASE, Cochrane, LILACS, Web of Science, SportDiscus, and the gray literature were searched to identify randomized controlled trials (RCTs).

DATA EXTRACTION

Two independent evaluators screened 2014 studies and extracted relevant data from those selected for the analysis. A risk of bias assessment was also performed with the RoB 2 tool and a strength of evidence assessment was performed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

DATA ANALYSIS

A total of 17 RCTs were included in the meta-analysis. With regard to risk of bias, 11 studies were rated as having "some concerns" and 6 as "high risk of bias." The consumption of EDs increased SBP, DBP, and CO in different time frames. More pronounced effects were seen on SBP at 60-80 minutes (4.71 mmHg; 95% CI: 2.97-6.45; GRADE: moderate), DBP at 120 minutes (4.51 mmHg; 95% CI: 2.60-6.42; GRADE: low), and CO at 30-40 minutes after consumption (0.43 L; 95% CI: 0.08-0.77; GRADE: very low). The effects of ED consumption on resting heart rate and QT/QTc interval were not significant (P ≤ 0.05). The assessment of endothelial function effects was not performed due to the absence of any RCTs meeting the inclusion criteria.

CONCLUSIONS

Acute consumption of EDs increases SBP, DBP, and CO in healthy adults. However, no alterations were observed in other cardiovascular parameters. The results should be interpreted with caution due to the limited number of studies included in the analysis.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42022295335.

Health effects of 100% fruit and vegetable juices: evidence from human subject intervention studies

The health effects of 100% fruit and vegetable juices (FVJ) represent a controversial topic. FVJ contain notable amounts of free sugars, but also vitamins, minerals, and secondary compounds with proven biological activities like (poly)phenols and carotenoids. The review aimed to shed light on the potential impact of 100% FVJ on human subject health, comprehensively assessing the role each type of juice may have in specific health outcomes for a particular target population, as reported in dietary interventions. The effects of a wide range of FVJ (orange, grapefruit, mandarin, lemon, apple, white, red, and Concord grapes, pomegranate, cranberry, chokeberry, blueberry, other minor berries, sweet and tart cherry, plum, tomato, carrot, beetroot, and watermelon, among others) were evaluated on a series of outcomes (anthropometric parameters, body composition, blood pressure and vascular function, lipid profile, glucose homeostasis, biomarkers of inflammation and oxidative stress, cognitive function, exercise performance, gut microbiota composition and bacterial infections), providing a thorough picture of the contribution of each FVJ to a health outcome. Some juices demonstrated their ability to exert potential preventive effects on some outcomes while others on other health outcomes, emphasising how the differential composition in bioactive compounds defines juice effects. Research gaps and future prospects were discussed. Although 100% FVJ appear to have beneficial effects on some cardiometabolic health outcomes, cognition and exercise performance, or neutral effects on anthropometric parameters and body composition, further efforts are needed to better understand the impact of 100% FVJ on human subject health.

A Survey on Blood Pressure Measurement Technologies: Addressing Potential Sources of Bias

Regular blood pressure (BP) monitoring in clinical and ambulatory settings plays a crucial role in the prevention, diagnosis, treatment, and management of cardiovascular diseases. Recently, the widespread adoption of ambulatory BP measurement devices has been predominantly driven by the increased prevalence of hypertension and its associated risks and clinical conditions. Recent guidelines advocate for regular BP monitoring as part of regular clinical visits or even at home. This increased utilization of BP measurement technologies has raised significant concerns regarding the accuracy of reported BP values across settings. In this survey, which focuses mainly on cuff-based BP monitoring technologies, we highlight how BP measurements can demonstrate substantial biases and variances due to factors such as measurement and device errors, demographics, and body habitus. With these inherent biases, the development of a new generation of cuff-based BP devices that use artificial intelligence (AI) has significant potential. We present future avenues where AI-assisted technologies can leverage the extensive clinical literature on BP-related studies together with the large collections of BP records available in electronic health records. These resources can be combined with machine learning approaches, including deep learning and Bayesian inference, to remove BP measurement biases and provide individualized BP-related cardiovascular risk indexes.

Sources of automatic office blood pressure measurement error: a systematic review

OBJECTIVE

Accurate and reliable blood pressure (BP) measurement is important for the prevention and treatment of hypertension. The oscillometric-based automatic office blood pressure measurement (AOBPM) is widely used in hospitals and clinics, but measurement errors are common in BP measurements. There is a lack of systematic review of the sources of measurement errors.

APPROACH

A systematic review of all existing research on sources of AOBPM errors. A search strategy was designed in six online databases, and all the literature published before October 2021 was selected. Those studies that used the AOBPM device to measure BP from the upper arm of subjects were included.

MAIN RESULTS

A total of 1365 studies were screened, and 224 studies were included in this final review. They investigated 22 common error sources with clinical AOBPM. Regarding the causes of BP errors, this review divided them into the following categories: the activities before measurement, patient's factors, measurement environment, measurement procedure, and device settings. 13 sources caused increased systolic and diastolic BP (SBP and DBP), 2 sources caused the decrease in SBP and DBP, only 1 source had no significant effect on BPs, and the other errors had a non-uniform effect (either increase or decrease in BPs). The error ranges for SBP and DBP were -14 to 33 mmHg and -6 to 19 mmHg, respectively.

SIGNIFICANCE

The measurement accuracy of AOBPM is susceptible to the influence of measurement factors. Interpreting BP readings need to be treated with caution in clinical measurements. This review made comprehensive evidence for the need for standardized BP measurements and provided guidance for clinical practitioners when measuring BP with AOBPM devices.

The impact of acute energy drink consumption on electrical heart disease: A systematic review and meta-analysis

AIMS

Energy Drink (ED)-associated cardiovascular emergency visits have increased in recent years. Although a toxicity threshold has been established for caffeine, the safety profile of whole ED consumption has not yet been defined.

METHODS

This systematic review was conducted following the PRISMA guidelines. Three reviewers conducted two separate systematic searches on PubMed on October 24 and December 3, 2019. Out of 250 potential records, 43 prospective clinical studies assessing the effects of ED on heart rate (HR) and/or any electrocardiographic (ECG) parameters were included. A meta-analysis was conducted to estimate pooled p-values using metap command for STATA 10.0.

RESULTS

After ED consumption, resting HR increased in 71.1% of studies (pooled p-value <0.001) but was only significant in 38%; HR during and after exercise increased in 55.5% (pooled p-value <0.001) and 71.4% of studies, respectively; QRS increased in all but two protocols; evidence on PR interval was contradictory, and corrected QT interval (QTc) increased compared to baseline in all but one study, exceeding the pathological limit value in two of them. T wave changes were seen in two studies, and one study reported a ratio of 5 to 1 in the number of ectopic beats.

CONCLUSION

Acute consumption of ED can alter the ECG in certain risk populations, posing a risk whose magnitude is yet to be determined. Caution should be exercised among at-risk and underage individuals but further research in these populations is warranted before restrictions are made.

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.

Small intestinal glucose and sodium absorption through calcium-induced calcium release and store-operated Ca2+ entry mechanisms

BACKGROUND AND PURPOSE

Luminal glucose enhances intestinal Ca²⁺ absorption through apical Ca_v 1.3 channels necessary for GLUT2-mediated glucose absorption. As these reciprocal mechanisms are not well understood, we investigated the regulatory mechanisms of intestinal [Ca²⁺ ]_cyt and SGLT1-mediated Na⁺ -glucose co-transports.

EXPERIMENTAL APPROACH

Glucose absorption and channel expression were examined in mouse upper jejunal epithelium using an Ussing chamber, immunocytochemistry and Ca²⁺ and Na⁺ imaging in single intestinal epithelial cells.

KEY RESULTS

Glucose induced jejunal I_sc via Na⁺ -glucose cotransporter 1 (SGLT1) operated more efficiently in the presence of extracellular Ca²⁺ . A crosstalk between luminal Ca²⁺ entry via plasma Ca_v 1.3 channels and the ER Ca²⁺ release through ryanodine receptor (RYR) activation in small intestinal epithelial cell (IEC) or Ca²⁺ -induced Ca²⁺ release (CICR) mechanism was involve in Ca²⁺ -mediated jejunal glucose absorption. The ER Ca²⁺ release through RyR triggered basolateral Ca²⁺ entry or store-operated Ca²⁺ entry (SOCE) mechanism and the subsequent Ca²⁺ entry via Na⁺ /Ca²⁺ exchanger 1 (NCX1) were found to be critical in Na⁺ -glucose cotransporter-mediated glucose absorption. Blocking RyR, SOCE and NCX1 inhibited glucose induced [Na⁺ ]_cyt and [Ca²⁺ ]_cyt in single IEC and protein expression and co-localization of STIM1/Orai1, RyR1 and NCX1 were detected in IEC and jejunal mucosa.

CONCLUSION AND IMPLICATIONS

Luminal Ca²⁺ influx through Ca_v 1.3 triggers the CICR through RyR1 to deplete the ER Ca²⁺ , which induces the basolateral STIM1/Orai1-mediated SOCE mechanism and the subsequent Ca²⁺ entry via NCX1 to regulate intestinal glucose uptake via Ca²⁺ signalling. Targeting these mechanisms in IEC may help to modulate blood glucose and sodium in the metabolic disease.

Beetroot (Beta Vulgaris L.) Extract Acutely Improves Heart Rate Variability Recovery Following Strength Exercise: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial-Pilot Study

OBJECTIVE

We assessed the acute effect of beetroot extract intake on cardiovascular and autonomic recovery subsequent to strength exercise.

METHODS

This is a crossover, randomized, double-blind and placebo-controlled trial. We assessed 16 subjects but only 12 healthy male adults completed the two protocols in two randomized days: Beetroot extract (600 mg in capsule) and placebo (600 mg starch in capsule). Beetroot extract or placebo was ingested, the subjects endured 120 minutes seated at rest, followed by a 75% 1RM strength exercise and then remained seated for 60 minutes at rest. Cardiorespiratory parameters, heart rate (HR) variability (HRV) (SDNN, rMSSD, pNN50, SD1, SD2 HF [ms²]) were estimated before, during exercise and during recovery from exercise.

RESULTS

ingestion of beetroot extract before exercise: accelerates the recovery of SBP following physical effort; improves HR recovery to baseline resting levels (beetroot protocol: change in ∼62% vs. placebo protocol: change in ∼80%), and intensifies the return of vagal HR control during recovery after exercise.

CONCLUSIONS

Beetroot extract acutely improved cardiovascular and autonomic recovery after exercise.

Development of an Enriched Polyphenol (Natural Antioxidant) Extract from Orange Juice (Citrus sinensis) by Adsorption on Macroporous Resins

Orange (Citrus sinensis) juice contains a high amount of antioxidant compounds, such as polyphenols and vitamins. The aim of this work was to develop an adsorption procedure for the quantitative recovery of polyphenols from fresh orange juice. Different macroporous resins have been selected to evaluate their affinity for phenolic compound in order to purify the antioxidant compounds from the orange juice. The main compounds of orange juice were firstly characterized using an UPLC-UV-HRMS to define the metabolite profile, and subsequently three different types of adsorbent (XAD-2, XAD-4, and XAD-16N) were tested to concentrate these bioactive compounds. The time of contact was selected based on kinetic studies, and subsequently the adsorption and elution conditions were optimized in order to maximize the recovery of phenolic compounds to obtain an extract rich of bioactive compounds. Lastly, antioxidant capacity of the orange juice extract of selected macroporous resin, obtained under optimized conditions, was determined by in vitro antioxidant assays.