Effects of purified anthocyanin supplementation on platelet chemokines in hypocholesterolemic individuals: a randomized controlled trial

Diet and Nutraceuticals for treatment and prevention of primary and secondary stroke: Emphasis on nutritional antiplatelet and antithrombotic agents

Ischemic stroke is a devastating disease that causes morbidity and mortality. Malnutrition following ischemic stroke is common in stroke patients. During the rehabilitation, the death rates of stroke patients are significantly increased due to malnutrition. Nutritional supplements such as protein, vitamins, fish, fish oils, moderate wine or alcohol consumption, nuts, minerals, herbal products, food colorants, marine products, fiber, probiotics and Mediterranean diets have improved neurological functions in stroke patients as well as their quality of life. Platelets and their mediators contribute to the development of clots leading to stroke. Ischemic stroke patients are treated with thrombolytics, antiplatelets, and antithrombotic agents. Several systematic reviews, meta-analyses, and clinical trials recommended that consumption of these nutrients and diets mitigated the vascular, peripheral, and central complications associated with ischemic stroke (Fig. 2). Particularly, these nutraceuticals mitigated the platelet adhesion, activation, and aggregation that intended to reduce the risks of primary and secondary stroke. Although these nutraceuticals mitigate platelet dysfunction, there is a greater risk of bleeding if consumed excessively. Moreover, malnutrition must be evaluated and adequate amounts of nutrients must be provided to stroke patients during intensive care units and rehabilitation periods. In this review, we have summarized the importance of diet and nutraceuticals in ameliorating neurological complications and platelet dysfunction with an emphasis on primary and secondary prevention of ischemic stroke.

Effectiveness of anthocyanin-containing foods and nutraceuticals in mitigating oxidative stress, inflammation, and cardiovascular health-related biomarkers: a systematic review of animal and human interventions

Cardiovascular diseases (CVDs) are a group of chronic health disorders prevalent worldwide that claim millions of lives yearly. Inflammation and oxidative stress are intricately associated with myocardial tissue damage, endothelial dysfunction, and increased odds of heart failure. Thus, dietary strategies aimed at decreasing the odds of CVDs are paramount. In this regard, the consumption of anthocyanins, natural pigments found in edible flowers, fruits, and vegetables, has attracted attention due to their potential to promote cardiovascular health. The main mechanisms of action linked with their protective effects on antioxidant and anti-inflammatory activities, serum lipid profile modulation, and other cardiovascular health parameters are explained and exemplified. However, little is known about the dose-dependency nature of the effects, which anthocyanin has better efficiency, and whether anthocyanin-containing foods display better in vivo efficacy than nutraceuticals (i.e., concentrated extracts containing higher levels of anthocyanins than foods). Thus, this systematic review focused on determining the effects of anthocyanin-containing foods and nutraceuticals on biomarkers associated with CVDs using animal studies and human interventions supported by in vitro mechanistic insights. Overall, the results showed that the regular consumption of anthocyanin-containing foods and nutraceuticals improved vascular function, lipid profile, and antioxidant and anti-inflammatory effects. The daily dosage, the participants' health status, and the duration of the intervention also significantly influenced the results.

A Comprehensive Review on Deep Eutectic Solvents and Its Use to Extract Bioactive Compounds of Pharmaceutical Interest

The extraction of bioactive compounds of pharmaceutical interest from natural sources has been significantly explored in recent decades. However, the extraction techniques used were not very efficient in terms of time and energy consumption; additionally, the solvents used for the extraction were harmful for the environment. To improve the environmental impact of the extractions and at the same time increase the extraction yields, several new extraction techniques were developed. Among the most used ones are ultrasound-assisted extraction and microwave-assisted extraction. These extraction techniques increased the yield and selectivity of the extraction in a smaller amount of time with a decrease in energy consumption. Nevertheless, a high volume of organic solvents was still used for the extraction, causing a subsequent environmental problem. Neoteric solvents appeared as green alternatives to organic solvents. Among the neoteric solvents, deep eutectic solvents were evidenced to be one of the best alternatives to organic solvents due to their intrinsic characteristics. These solvents are considered green solvents because they are made up of natural compounds such as sugars, amino acids, and carboxylic acids having low toxicity and high degradability. In addition, they are simple to prepare, with an atomic economy of 100%, with attractive physicochemical properties. Furthermore, the huge number of compounds that can be used to synthesize these solvents make them very useful in the extraction of bioactive compounds since they can be tailored to be selective towards a specific component or class of components. The main aim of this paper is to give a comprehensive review which describes the main properties, characteristics, and production methods of deep eutectic solvents as well as its application to extract from natural sources bioactive compounds with pharmaceutical interest. Additionally, an overview of the more recent and sustainable extraction techniques is also given.

Single anthocyanins effectiveness modulating inflammation markers in obesity: dosage and matrix composition analysis

Anthocyanins (ACNs) are phytochemicals with numerous bioactivities, e.g., antioxidant and anti-inflammatory. Health benefits from consuming ACN-rich foods, extracts, and supplements have been studied in clinical trials (CT). However, the individual effect of single ACNs and their correlation with doses and specific bioactivities or molecular targets have not been thoroughly analyzed. This review shows a recompilation of single anthocyanins composition and concentrations used in CT, conducted to investigate the effect of these anti-inflammatory derivatives in obese condition. Single anthocyanin doses with changes in the levels of frequently monitored markers were correlated. In addition, the analysis was complemented with reports of studies made in vitro with single ACNs. Anthocyanins' efficacy in diseases with high baseline obesity-related inflammation markers was evidenced. A poor correlation was found between most single anthocyanin doses and level changes of commonly monitored markers. Correlations between cyanidin, delphinidin, and pelargonidin derivatives and specific molecular targets were proposed. Our analysis showed that knowledge of specific compositions and anthocyanin concentrations determined in future studies would provide more information about mechanisms of action.

Anthocyanin Effects on Vascular and Endothelial Health: Evidence from Clinical Trials and Role of Gut Microbiota Metabolites

Hypertension and derived cardiovascular disease (CVD) are among the leading causes of death worldwide. Increased oxidative stress and inflammatory state are involved in different alterations in endothelial functions that contribute to the onset of CVD. Polyphenols, and in particular anthocyanins, have aroused great interest for their antioxidant effects and their cardioprotective role. However, anthocyanins are rarely detected in blood serum because they are primarily metabolized by the gut microbiota. This review presents studies published to date that report the main results from clinical studies on the cardioprotective effects of anthocyanins and the role of the gut microbiota in the metabolism and bioavailability of anthocyanins and their influence on the composition of the microbiota. Even if it seems that anthocyanins have a significant effect on vascular health, more studies are required to better clarify which molecules and doses show vascular benefits without forgetting the crucial role of the microbiota.

Effects of anthocyanin supplementation on blood lipid levels: a systematic review and meta-analysis

Introduction

Dyslipidemia is a major cardiovascular disease risk factor associated with increased mortality. The intake of plant food-derived bioactive compounds is associated with beneficial cardiovascular effects, including decreased blood lipid levels and cardiovascular risk. We aimed to evaluate the effects of anthocyanin intake on blood lipid levels by analyzing relevant randomized controlled trials.

Methods

We searched the PubMed and Embase databases using the "Patient/Population, Intervention, Comparison, and Outcomes" format to determine whether anthocyanin supplementation intervention affected blood lipid levels compared with placebo supplementation in human participants.

Results

A total of 41 studies with 2,788 participants were included in the meta-analysis. Anthocyanin supplementation significantly reduced triglyceride [standardized mean difference (SMD) = -0.10; 95% confidence interval [CI], -0.18, -0.01) and low-density lipoprotein-cholesterol (SMD = -0.16; 95% CI -0.26, -0.07) levels and increased high-density lipoprotein-cholesterol levels (SMD = 0.42; 95% CI 0.20, 0.65).

Discussion

Anthocyanin supplementation significantly improved blood lipid component levels in the included studies. Larger, well-designed clinical trials are needed to further investigate the effects of anthocyanin intake on blood lipid levels and the safety of anthocyanin supplementation for treating dyslipidemia.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021257087, identifier: CRD42021257087.

How effective are anthocyanins on healthy modification of cardiometabolic risk factors: a systematic review and meta-analysis

BACKGROUND

In this meta-analysis, findings from recent studies on the preventive properties of anthocyanins (ACN) against cardiovascular disease are summarized.

METHODS

MEDLINE, PubMed, Embase, Cochrane Library, and Google Scholar were searched and 2512 studies were found in a preliminary search. After screening of titles and abstracts, 47 studies met the inclusion criteria (randomized clinical trial design and sufficient data of outcomes). Studies were excluded based on the following criteria: incomplete data; obscurely reported outcomes, or lack of control groups; and animal studies.

RESULTS

The results showed that intervention with ACNs resulted in a significant decrease in body mass index ((MD),- 0.21; 95% CI, - 0.38, - 0.04; P < 0.001) and body fat mass (MD: - 0.3%, 95% CI - 0.42 to - 0.18%, p < 0.001). Pooled data comparing ACN with control showed statistically significant effect on fasting blood sugar and HbA1c. However, the reductions were significantly more in the subjects with type 2 diabetes and in those who used ACN as supplement/extract. The subgroup analysis test showed that there was a significant effect of ACN on triglyceride concentrations, total cholesterol, LDL-C and HDL-C concentrations in all subgroups of participants (with vs. without dyslipidemia at baseline) and intervention type (supplement/extract vs. food). However, we did not observe any significant effect on apo A and apo B concentrations.

CONCLUSIONS

ACN intake in the forms of natural foods and supplements can induce healthy changes in body fat mass, glycemic and lipidemic status and these effects are more prominent in the subjects with above-normal values. This meta-analysis was registered at http://www.crd.york.ac.uk/Prospero (Registration no. CRD42021286466).

Regular Consumption of Cocoa and Red Berries as a Strategy to Improve Cardiovascular Biomarkers via Modulation of Microbiota Metabolism in Healthy Aging Adults

The aim of the present study was to analyze the effects of cocoa flavanols and red berry anthocyanins on cardiovascular biomarkers, such as homocysteine, angiotensin-converting enzyme (ACE), nitric oxide (NO), flow-mediated vasodilation (FMD), blood pressure and lipid profile. Additionally, we aimed to ascertain their possible interactions with microbiota related metabolites, such as secondary bile acids (SBA), short-chain fatty acids (SCFA) and trimethylamine N-oxide (TMAO). A randomized, parallel-group study, single-blind for the research team, was performed on 60 healthy volunteers between the ages of 45 and 85, who consumed 2.5 g/day of cocoa powder (9.59 mg/day of total flavanols), 5 g/day of a red berry mixture (13.9 mg/day of total anthocyanins) or 7.5 g/day of a combination of both for 12 weeks. The group that had consumed cocoa showed a significant reduction in TMAO (p = 0.03) and uric acid (p = 0.01) levels in serum, accompanied by an increase in FMD values (p = 0.03) and total polyphenols. corrected by creatinine (p = 0.03) after the intervention. These latter values negatively correlated with the TMAO concentration (R = -0.57, p = 0.02). Additionally, we observed an increase in carbohydrate fermentation in the groups that had consumed cocoa (p = 0.04) and red berries (p = 0.04) between the beginning and the end of the intervention. This increase in carbohydrate fermentation was correlated with lower levels of TC/HDL ratio (p = 0.01), systolic (p = 0.01) and diastolic blood pressure (p = 0.01). In conclusion, our study showed a positive modulation of microbiota metabolism after a regular intake of cocoa flavanols and red berry anthocyanins that led to an improvement in cardiovascular function, especially in the group that consumed cocoa.

The effects of phytochemicals on serum triglycerides in subjects with hypertriglyceridemia: A systematic review of randomized controlled trials

This systematic review aimed to evaluate the efficacy of phytochemicals on lipid parameters in patients with hypertriglyceridemia (HTG). A comprehensive search was performed in PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar from inception up to October 2021 to recognize randomized controlled trials (RCTs) assessing the effects of phytochemicals on lipid profiles in patients with HTG. Forty-eight RCTs including 53 arms and comprising 3,478 HTG patients met the eligibility criteria. Phytochemicals significantly reduced the serum levels of triglycerides in 32 out 53 arms, total cholesterol in 22 out of 51, low-density lipoprotein cholesterol in 21 out of 48, very low-density lipoprotein cholesterol in 1 out of 5, apolipoprotein B in 2 out of 4, and lipoprotein(a) levels in 2 out of 4 arms. Furthermore, phytochemicals supplementation increased the levels of high-density lipoprotein cholesterol in 15 out of 48 arms. In brief, phytochemicals supplementation might have beneficial effects on HTG. In most of the studies, phytochemicals had a favorable effect on at least one of the lipid parameters.

No Effect of Isolated Anthocyanins from Bilberry Fruit and Black Rice on LDL Cholesterol or other Biomarkers of Cardiovascular Disease in Adults with Elevated Cholesterol: A Randomized, Placebo-Controlled, Cross-Over Trial

SCOPE

Some dietary interventions with berry fruits, berry fruit extracts, and purified anthocyanins have been reported to beneficially alter lipoprotein profiles in hyperlipidemic participants. The major anthocyanins in human diets are glycosides of cyanidin and delphinidin, and structure can influence both absorption and bioactivity. The aim of this study is to determine the effects of two major types of anthocyanins on low-density lipoprotein cholesterol and other cardiometabolic markers for cardiovascular disease (CVD) risk in hyperlipidemic individuals.

METHODS AND RESULTS

Fifty-two hyperlipidemic participants complete this randomized, placebo-controlled, double-blind, three arm crossover trial. Participants ingest capsules containing 320 mg of anthocyanins (bilberry trihydroxy-type or black rice dihydroxy-type) or placebo once daily for 28 days. Biomarkers of CVD risk are measured before and after the intervention period. Compared to the placebo, neither anthocyanin treatment significantly (p < 0.05) changes circulating levels of lipoproteins (total-/high-density lipoprotein (HDL)-/low-density lipoprotein (LDL)-cholesterol, triglycerides, Apolipoprotein B (ApoB)), biomarkers of glycemic control (fasting glucose, fructosamine), biomarkers of HDL function (ApoA1, HDL3, paraoxonase-1 (PON1) arylesterase, and lactonase activities), or plasma bile acids.

CONCLUSIONS

These data do not support the notion that regular consumption of anthocyanins beneficially affects glycemic control or lipoprotein profiles or functions. It is possible the no effect observation is due to the relatively short duration of treatments.

The Role of Anthocyanin in Modulating Diabetic Cardiovascular Disease and Its Potential to Be Developed as a Nutraceutical

Cardiovascular disease (CVD) is directly linked to diabetes mellitus (DM), and its morbidity and mortality are rising at an alarming rate. Individuals with DM experience significantly worse clinical outcomes due to heart failure as a CVD consequence than non-diabetic patients. Hyperglycemia is the main culprit that triggers the activation of oxidative damage, inflammation, fibrosis, and apoptosis pathways that aggravate diabetic CVD progression. In recent years, the development of phytochemical-based nutraceutical products for diabetic treatment has risen due to their therapeutic properties. Anthocyanin, which can be found in various types of plants, has been proposed for preventing and treating various diseases, and has elicited excellent antioxidative, anti-inflammation, anti-fibrosis, and anti-apoptosis effects. In preclinical and clinical studies, plants rich in anthocyanin have been reported to attenuate diabetic CVD. Therefore, the development of anthocyanin as a nutraceutical in managing diabetic CVD is in demand. In this review, we unveil the role of anthocyanin in modulating diabetic CVD, and its potential to be developed as a nutraceutical for a therapeutic strategy in managing CVD associated with DM.

Effects of the Treatment with Flavonoids on Metabolic Syndrome Components in Humans: A Systematic Review Focusing on Mechanisms of Action

Diets high in bioactive compounds, such as polyphenols, have been used to mitigate metabolic syndrome (MetS). Polyphenols are a large group of naturally occurring bioactive compounds, classified into two main classes: non-flavonoids and flavonoids. Flavonoids are distributed in foods, such as fruits, vegetables, tea, red wine, and cocoa. Studies have already demonstrated the benefits of flavonoids on the cardiovascular and nervous systems, as well as cancer cells. The present review summarizes the results of clinical studies that evaluated the effects of flavonoids on the components of the MetS and associated complications when offered as supplements over the long term. The results show that flavonoids can significantly modulate several metabolic parameters, such as lipid profile, blood pressure, and blood glucose. Only theaflavin and catechin were unable to affect metabolic parameters. Moreover, only body weight and body mass index were unaltered. Thus, the evidence presented in this systematic review offers bases in support of a flavonoid supplementation, held for at least 3 weeks, as a strategy to improve several metabolic parameters and, consequently, reduce the risk of diseases associated with MetS. This fact becomes stronger due to the rare side effects reported with flavonoids.

Cyanidin-3-O-β-Glucoside Attenuates Platelet Chemokines and Their Receptors in Atherosclerotic Inflammation of ApoE-/- Mice

Platelet chemokines play well-established roles in the atherosclerotic inflammation. Cyanidin-3-O-β-glucoside (Cy-3-g) is one of the main bioactive compounds in anthocyanins, but its effects on chemokines during atherosclerosis have not been determined yet. In the present study, ApoE^-/- mice were fed on the chow diet, high-fat diet (HFD), and HFD-supplemented Cy-3-g at 200, 400, and 800 mg/kg diet. After 16 weeks, Cy-3-g significantly alleviated the atherosclerotic lesion and inhibited platelet aggregation and activation. Moreover, Cy-3-g significantly reduced inflammatory chemokines CXCL4, CXCL7, CCL5, CXCL5, CXCL12, and CCL2 in plasma and downregulated CXCR4, CXCR7, and CCR5 on platelets and peripheral blood mononuclear cells. Besides, Cy-3-g decreased the mRNA of TNFα, IFNγ, ICAM-1, VCAM-1, CD68, MMP7, CCL5, CXCR4, and CCR5 in the aorta of mice. Therefore, it suggests that Cy-3-g plays important preventive roles in the process of atherosclerosis via attenuating chemokines and receptors in ApoE^-/- mice.

Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients

Aim

Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients.

Methods

Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis.

Results

A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009).

Conclusions

In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.

Differences in the Effects of Anthocyanin Supplementation on Glucose and Lipid Metabolism According to the Structure of the Main Anthocyanin: A Meta-Analysis of Randomized Controlled Trials

The effectiveness of anthocyanins may differ according to their chemical structures; however, randomized clinical controlled trials (RCTs) or meta-analyses that examine the consequences of these structural differences have not been reported yet. In this meta-analysis, anthocyanins in test foods of 18 selected RCTs were categorized into three types: cyanidin-, delphinidin-, and malvidin-based. Delphinidin-based anthocyanins demonstrated significant effects on triglycerides (mean difference (MD): −0.24, p < 0.01), low-density lipoprotein cholesterol (LDL-C) (MD: −0.28, p < 0.001), and high-density lipoprotein cholesterol (HDL-C) (MD: 0.11, p < 0.01), whereas no significant effects were observed for cyanidin- and malvidin-based anthocyanins. Although non-significant, favorable effects on total cholesterol (TC) and HDL-C were observed for cyanidin- and malvidin-based anthocyanins, respectively (both p < 0.1). The ascending order of effectiveness on TC and LDL-C was delphinidin-, cyanidin-, and malvidin-based anthocyanins, and the differences among the three groups were significant (both p < 0.05). We could not confirm the significant effects of each main anthocyanin on glucose metabolism; however, insulin resistance index changed positively and negatively with cyanidin- and delphinidin-based anthocyanins, respectively. Therefore, foods containing mainly unmethylated anthocyanins, especially with large numbers of OH groups, may improve glucose and lipid metabolism more effectively than those containing methylated anthocyanins.

Role of Resveratrol in Prevention and Control of Cardiovascular Disorders and Cardiovascular Complications Related to COVID-19 Disease: Mode of Action and Approaches Explored to Increase Its Bioavailability

Resveratrol is a phytoalexin produced by many plants as a defense mechanism against stress-inducing conditions. The richest dietary sources of resveratrol are berries and grapes, their juices and wines. Good bioavailability of resveratrol is not reflected in its high biological activity in vivo because of resveratrol isomerization and its poor solubility in aqueous solutions. Proteins, cyclodextrins and nanomaterials have been explored as innovative delivery vehicles for resveratrol to overcome this limitation. Numerous in vitro and in vivo studies demonstrated beneficial effects of resveratrol in cardiovascular diseases (CVD). Main beneficial effects of resveratrol intake are cardioprotective, anti-hypertensive, vasodilatory, anti-diabetic, and improvement of lipid status. As resveratrol can alleviate the numerous factors associated with CVD, it has potential as a functional supplement to reduce COVID-19 illness severity in patients displaying poor prognosis due to cardio-vascular complications. Resveratrol was shown to mitigate the major pathways involved in the pathogenesis of SARS-CoV-2 including regulation of the renin-angiotensin system and expression of angiotensin-converting enzyme 2, stimulation of immune system and downregulation of pro-inflammatory cytokine release. Therefore, several studies already have anticipated potential implementation of resveratrol in COVID-19 treatment. Regular intake of a resveratrol rich diet, or resveratrol-based complementary medicaments, may contribute to a healthier cardio-vascular system, prevention and control of CVD, including COVID-19 disease related complications of CVD.

Anthocyanins Recovered from Agri-Food By-Products Using Innovative Processes: Trends, Challenges, and Perspectives for Their Application in Food Systems

Anthocyanins are naturally occurring phytochemicals that have attracted growing interest from consumers and the food industry due to their multiple biological properties and technological applications. Nevertheless, conventional extraction techniques based on thermal technologies can compromise both the recovery and stability of anthocyanins, reducing their global yield and/or limiting their application in food systems. The current review provides an overview of the main innovative processes (e.g., pulsed electric field, microwave, and ultrasound) used to recover anthocyanins from agri-food waste/by-products and the mechanisms involved in anthocyanin extraction and their impacts on the stability of these compounds. Moreover, trends and perspectives of anthocyanins' applications in food systems, such as antioxidants, natural colorants, preservatives, and active and smart packaging components, are addressed. Challenges behind anthocyanin implementation in food systems are displayed and potential solutions to overcome these drawbacks are proposed.

Protocatechuic Acid Protects Platelets from Apoptosis via Inhibiting Oxidative Stress-Mediated PI3K/Akt/GSK3β Signaling

Oxidative stress plays crucial roles in initiating platelet apoptosis that facilitates the progression of cardiovascular diseases (CVDs). Protocatechuic acid (PCA), a major metabolite of anthocyanin cyanidin-3-O-β-glucoside (Cy-3-g), exerts cardioprotective effects. However, underlying mechanisms responsible for such effects remain unclear. Here, we investigate the effect of PCA on platelet apoptosis and the underlying mechanisms in vitro. Isolated human platelets were treated with hydrogen peroxide (H₂O₂) to induce apoptosis with or without pretreatment with PCA. We found that PCA dose-dependently inhibited H₂O₂-induced platelet apoptosis by decreasing the dissipation of mitochondrial membrane potential, activation of caspase-9 and caspase-3, and decreasing phosphatidylserine exposure. Additionally, the distributions of Bax, Bcl-xL, and cytochrome c mediated by H₂O₂ in the mitochondria and the cytosol were also modulated by PCA treatment. Moreover, the inhibitory effects of PCA on platelet caspase-3 cleavage and phosphatidylserine exposure were mainly mediated by downregulating PI3K/Akt/GSK3β signaling. Furthermore, PCA dose-dependently decreased reactive oxygen species (ROS) generation and the intracellular Ca²⁺ concentration in platelets in response to H₂O₂. N-Acetyl cysteine (NAC), a ROS scavenger, markedly abolished H₂O₂-stimulated PI3K/Akt/GSK3β signaling, caspase-3 activation, and phosphatidylserine exposure. The combination of NAC and PCA did not show significant additive inhibitory effects on PI3K/Akt/GSK3β signaling and platelet apoptosis. Thus, our results suggest that PCA protects platelets from oxidative stress-induced apoptosis through downregulating ROS-mediated PI3K/Akt/GSK3β signaling, which may be responsible for cardioprotective roles of PCA in CVDs.

Ginsenosides Rb2 and Rd2 isolated from Panax notoginseng flowers attenuate platelet function through P2Y12-mediated cAMP/PKA and PI3K/Akt/Erk1/2 signaling

Saponins derived from Panax notoginseng root are widely used as herbal medicines and dietary supplements due to their wide range of health benefits. However, the effects of those from Panax notoginseng flowers (PNF) on platelet function and thrombus formation remain largely unknown. Using a series of platelet function assays, we found that G-Rb2 and G-Rd2, among the ten PNF saponin monomers, significantly inhibited human platelet aggregation and activation induced by adenosine diphosphate (ADP) in vitro. The 50% inhibitory concentration (IC50) of G-Rb2 and G-Rd2 against ADP-induced platelet aggregation was 85.5 ± 4.5 μg mL-1 and 51.4 ± 4.6 μg mL-1, respectively. Mechanistically, G-Rb2 and G-Rd2 could effectively modulate platelet P2Y12-mediated signaling by up-regulating cAMP/PKA signaling and down-regulating PI3K/Akt/Erk1/2 signaling pathways. Co-incubation of the P2Y12 antagonist cangrelor with either G-Rb2 or G-Rd2 did not show significant additive inhibitory effects. G-Rb2 and G-Rd2 also substantially suppressed thrombus growth in a FeCl3-induced murine arteriole thrombosis model in vivo. Interestingly, G-Rd2 generally exhibited more potent inhibitory effects on platelet function and thrombus formation than G-Rb2. Thus, our data suggest that PNF-derived G-Rb2 and G-Rd2 effectively attenuate platelet hyperactivity through modulating signaling pathways downstream of P2Y12, which indicates G-Rb2 and G-Rd2 may play important preventive roles in thrombotic diseases.

Food Bioactive Compounds and Emerging Techniques for Their Extraction: Polyphenols as a Case Study

Experimental studies have provided convincing evidence that food bioactive compounds (FBCs) have a positive biological impact on human health, exerting protective effects against non-communicable diseases (NCD) including cancer and cardiovascular (CVDs), metabolic, and neurodegenerative disorders (NDDs). These benefits have been associated with the presence of secondary metabolites, namely polyphenols, glucosinolates, carotenoids, terpenoids, alkaloids, saponins, vitamins, and fibres, among others, derived from their antioxidant, antiatherogenic, anti-inflammatory, antimicrobial, antithrombotic, cardioprotective, and vasodilator properties. Polyphenols as one of the most abundant classes of bioactive compounds present in plant-based foods emerge as a promising approach for the development of efficacious preventive agents against NCDs with reduced side effects. The aim of this review is to present comprehensive and deep insights into the potential of polyphenols, from their chemical structure classification and biosynthesis to preventive effects on NCDs, namely cancer, CVDs, and NDDS. The challenge of polyphenols bioavailability and bioaccessibility will be explored in addition to useful industrial and environmental applications. Advanced and emerging extraction techniques will be highlighted and the high-resolution analytical techniques used for FBCs characterization, identification, and quantification will be considered.

The Therapeutic Potential of Anthocyanins: Current Approaches Based on Their Molecular Mechanism of Action

Anthocyanins are natural phenolic pigments with biological activity. They are well-known to have potent antioxidant and antiinflammatory activity, which explains the various biological effects reported for these substances suggesting their antidiabetic and anticancer activities, and their role in cardiovascular and neuroprotective prevention. This review aims to comprehensively analyze different studies performed on this class of compounds, their bioavailability and their therapeutic potential. An in-depth look in preclinical, in vitro and in vivo, and clinical studies indicates the preventive effects of anthocyanins on cardioprotection, neuroprotection, antiobesity as well as their antidiabetes and anticancer effects.

Anthocyanins: A Comprehensive Review of Their Chemical Properties and Health Effects on Cardiovascular and Neurodegenerative Diseases

Anthocyanins are a class of water-soluble flavonoids widely present in fruits and vegetables. Dietary sources of anthocyanins include red and purple berries, grapes, apples, plums, cabbage, or foods containing high levels of natural colorants. Cyanidin, delphinidin, malvidin, peonidin, petunidin, and pelargonidin are the six common anthocyanidins. Following consumption, anthocyanin, absorption occurs along the gastrointestinal tract, the distal lower bowel being the place where most of the absorption and metabolism occurs. In the intestine, anthocyanins first undergo extensive microbial catabolism followed by absorption and human phase II metabolism. This produces hybrid microbial-human metabolites which are absorbed and subsequently increase the bioavailability of anthocyanins. Health benefits of anthocyanins have been widely described, especially in the prevention of diseases associated with oxidative stress, such as cardiovascular and neurodegenerative diseases. Furthermore, recent evidence suggests that health-promoting effects attributed to anthocyanins may also be related to modulation of gut microbiota. In this paper we attempt to provide a comprehensive view of the state-of-the-art literature on anthocyanins, summarizing recent findings on their chemistry, biosynthesis, nutritional value and on their effects on human health.

Short-term, but not acute, intake of New Zealand blackcurrant extract improves insulin sensitivity and free-living postprandial glucose excursions in individuals with overweight or obesity

Abstract

Impaired postprandial glucose handling and low-grade systemic inflammation are risk factors for developing insulin resistance in individuals with overweight or obesity. Acute ingestion of anthocyanins improves postprandial glucose responses to a single carbohydrate-rich meal under strictly controlled conditions.

Purpose

Examine whether acute and short-term supplementation with anthocyanin-rich New Zealand blackcurrant (NZBC) extract can improve postprandial glucose responses to mixed-macronutrient meals.

Methods

Twenty-five overweight (BMI > 25 kg m²) sedentary individuals participated in one of the following double-blinded, randomised controlled trials: (1) ingestion of 600 mg NZBC extract or placebo prior to consumption of a high-carbohydrate, high-fat liquid meal (n = 12); (2) 8-days supplementation with NZBC extract (600 mg day⁻¹) or placebo, with insulin sensitivity and markers of inflammation assessed on day-7, and free-living postprandial glucose (continuous glucose monitoring) assessed on day-8 (n = 13).

Results

A single dose of NZBC extract had no effect on 3 h postprandial glucose, insulin or triglyceride responses. However, in response to short-term NZBC extract supplementation insulin sensitivity was improved (+ 22%; P = 0.011), circulating C-reactive protein concentrations decreased (P = 0.008), and free-living postprandial glucose responses to both breakfast and lunch meals were reduced (− 9% and − 8%, respectively; P < 0.05), compared to placebo.

Conclusion

These novel results indicate that repeated intake, rather than a single dose of NZBC extract, is required to induce beneficial effects on insulin sensitivity and postprandial glucose handling in individuals with overweight or obesity. Continuous glucose monitoring enabled an effect of NZBC extract to be observed under free-living conditions and highlights the potential of anthocyanin-rich supplements as a viable strategy to reduce insulin resistance.

Effect of dietary anthocyanins on biomarkers of glycemic control and glucose metabolism: A systematic review and meta-analysis of randomized clinical trials

Anthocyanins, as natural food colorants, are bioactive substances with several health advantages. In this research, the effects of dietary anthocyanins on biomarkers of glycemic control and glucose metabolism was evaluated through a meta-analysis. The results revealed a significant reduction in levels of fasting blood sugar (FBS; -2.70 mg/dl, 95% CI: -4.70 to -1.31; P < 0.001), 2-h postprandial glucose (2-h PPG; -11.1 mg/dl, 95% CI: -18.7 to -3.48; P = 0.004), glycated hemoglobin (HbA1c; -11.1 mg/dl, 95% CI: -18.7 to -3.48; P = 0.004), homeostasis model assessment of insulin resistance (HOMA-IR; -0.54, 95% CI: -0.94 to -0.14; P = 0.008), resistin (-1.23 µg/l, 95% CI: -2.40 to -0.05; P = 0.041), and plasminogen activator inhibitor-1 (PAI-1; -5.09 µg/l, 95% CI: -9.45 to -0.73; P = 0.022) following administration of anthocyanins, whilst changes in the levels of fasting insulin (0.33 mU/l, 95% CI: -0.18 to 0.85; P = 0.207) and C-peptide (-0.02 µg/l, 95 %CI: -0.20 to 0.16; P = 0.816) was not statistically significant. Consumption of anthocyanins for >8 weeks and at doses >300 mg/day significantly reduced levels of FBS, 2-h PPG, HbA1c, and HOMA-IR. Moreover, anthocyanins administration reduced the levels of FBS, 2-h PPG, HbA1c, and HOMA-IR in type 2 diabetic subjects and HOMA-IR in overweight/obese individuals. Overall, dietary anthocyanins can be used as an adjuvant therapy to improve biomarkers of glycemic control and glucose metabolism specially in diabetic subjects.

Anthocyanin supplementation improves anti-oxidative and anti-inflammatory capacity in a dose-response manner in subjects with dyslipidemia

BACKGROUND

Anthocyanins, one of the major plant bioactive substances, possess anti-oxidative and anti-inflammatory capacity. However, their dose-response relationship has remained unclear. The present study investigated the dose-response relationship of anthocyanins with oxidative stress and inflammation in subjects with dyslipidemia.

DESIGN

and Participants: A total of 169 participants with dyslipidemia were randomly assigned to placebo (n = 43), anthocyanins 40 mg/day (n = 44), 80 mg/day (n = 40), or 320 mg/day (n = 42) groups. Urine 8-iso-prostaglandin F2α (8-iso-PGF2α), 8-hydroxy-2'-deoxyguanosine (8-OHdG) and serum malonaldehyde (MDA), total superoxide dismutase (T-SOD), UA (uric acid), interleukin (IL)-6, IL-10, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were measured at baseline, at 6 weeks, and at 12 weeks.

RESULTS

Anthocyanin supplementation (320 mg/day) for 6 weeks significantly improved T-SOD versus baseline (P < 0.05). A slight reduction in serum IL-6, TNF-α, and urine 8-iso-PGF2α from the baseline was observed at 12 weeks in the group receiving 40 mg/day anthocyanins. Anthocyanins (80 mg/day) significantly reduced serum IL-6 (-20%), TNF-α (-11%) and urine 8-iso-PGF2α (-27%) versus baseline (P < 0.05). Moreover, 320 mg/day anthocyanin supplementation reduced serum IL-6 (-40%), TNF-α (-21%), MDA (-20%) and urine 8-iso-PGF2α (-37%) and 8-OHdG (-36%) than 80 mg/day and 40 mg/day anthocyanins, P value < 0.05. Anthocyanin supplementation has dose-response relationships with decreased inflammatory cytokines IL-6, TNF-α and oxidative stress biomarkers 8-iso-PGF2α, 8-OHdG and MDA (P for trend, <0.05). Furthermore, a strong positive correlation was observed between the changes in the urine 8-iso-PGF2α , 8-OHdG levels and serum IL-6 levels in subjects from anthocyanin groups after 12 weeks of treatment.

CONCLUSIONS

Supplementation of anthocyanins for 12 weeks positively improved the anti-oxidative and anti-inflammatory capacity in a dose-response manner in individuals with dyslipidemia.

The Colors of Health: Chemistry, Bioactivity, and Market Demand for Colorful Foods and Natural Food Sources of Colorants

There is an increasing consumer demand for natural colors in foods. However, there is a limited number of available natural food sources for use by the food industry because of technical and regulatory limitations. Natural colors are less stable and have less vibrant hues compared to their synthetic color counterparts. Natural pigments also have known health benefits that are seldom leveraged by the food industry. Betalains, carotenoids, phycocyanins, and anthocyanins are major food colorants used in the food industry that have documented biological effects, particularly in the prevention and management of chronic diseases such as diabetes, obesity, and cardiovascular disease. The color industry needs new sources of stable, functional, and safe natural food colorants. New opportunities include sourcing new colors from microbial sources and via the use of genetic biotechnology. In all cases, there is an imperative need for toxicological evaluation to pave the way for their regulatory approval.

Impact of dietary anthocyanins on systemic and vascular inflammation: Systematic review and meta-analysis on randomised clinical trials

Anthocyanins are natural bioactive compounds that have several health benefits. This systematic review and meta-analysis assessed the impact of dietary anthocyanins on markers of systemic and vascular inflammation. Meta-analysis of 32 randomised controlled trials indicated that dietary anthocyanins significantly decreased levels of C-reactive protein (CRP; -0.33 mg/l, 95% CI: -0.55 to -0.11, P = 0.003), interleukin-6 (IL-6; -0.41 ρg/ml, 95% CI: -0.70 to -0.13, P = 0.004), tumor necrosis factor-alpha (TNF-α; -0.64 ρg/ml, 95% CI: -1.18 to -0.09, P = 0.023), intercellular adhesion molecule-1 (-52.4 ng/ml, 95% CI: -85.7 to -19.1, P = 0.002), and vascular adhesion molecule-1 (VCAM-1; -49.6 ng/ml, 95% CI: -72.7 to -26.5, P < 0.001) while adiponectin level was significantly increased (0.75 μg/ml, 95% CI: 0.23 to 1.26, P = 0.004). The levels of interleukin-1β (IL-1β; -0.45 ρg/ml, 95% CI: -3.77 to 2.88, P = 0.793) and P-selectin (-6.98 ng/ml, 95% CI: -18.1 to 4.15, P = 0.219) did not significantly change. Subgroup analyses showed that administration of higher doses of anthocyanins (>300 mg/day) significantly decreased levels of CRP, IL-6, TNF-α, and VCAM-1. The results indicate that dietary anthocyanins reduce the levels of systemic and vascular inflammation in the subjects.

Relation of Fruits and Vegetables with Major Cardiometabolic Risk Factors, Markers of Oxidation, and Inflammation

Noncommunicable diseases (NCDs) are considered to be the leading cause of death worldwide. Inadequate fruit and vegetable intake have been recognized as a risk factor for almost all NCDs (type 2 diabetes mellitus, cancer, and cardiovascular and neurodegenerative diseases). The main aim of this review is to examine the possible protective effect that fruit and vegetable consumption or their bioactive compounds may have on the development of NCDs such as atherosclerosis. The accumulated evidence on the protective effects of adequate consumption of fruits and vegetables in some cases, or the lack of evidence in others, are summarized in the present review. The main conclusion of this review is that well-designed, large-scale, long-term studies are needed to truly understand the role fruit and vegetable consumption or their bioactive compounds have in atherosclerosis.

Coenzyme Q10 Upregulates Platelet cAMP/PKA Pathway and Attenuates Integrin αIIbβ3 Signaling and Thrombus Growth

SCOPE

Platelet integrin αIIbβ3 is the key mediator of atherothrombosis. Supplementation of coenzyme Q10 (CoQ10), a fat-soluble molecule that exists in various foods, exerts protective cardiovascular effects. This study aims to investigate whether and how CoQ10 acts on αIIbβ3 signaling and thrombosis, the major cause of cardiovascular diseases.

METHODS AND RESULTS

Using a series of platelet functional assays in vitro, it is demonstrated that CoQ10 reduces human platelet aggregation, granule secretion, platelet spreading, and clot retraction. It is further demonstrated that CoQ10 inhibits platelet integrin αIIbβ3 outside-in signaling. These inhibitory effects are mainly mediated by upregulating cAMP/PKA pathway, where CoQ10 stimulates the A_2A adenosine receptor and decreases phosphodiesterase 3A phosphorylation. Moreover, CoQ10 attenuates murine thrombus growth and vessel occlusion in a ferric chloride (FeCl₃ )-induced thrombosis model in vivo. Importantly, the randomized, double-blind, placebo-controlled clinical trial in dyslipidemic patients demonstrates that 24 weeks of CoQ10 supplementation increases platelet CoQ10 concentrations, enhances the cAMP/PKA pathway, and attenuates αIIbβ3 outside-in signaling, leading to decreased platelet aggregation and granule release.

CONCLUSION

Through upregulating the platelet cAMP/PKA pathway, and attenuating αIIbβ3 signaling and thrombus growth, CoQ10 supplementation may play an important protective role in patients with risks of cardiovascular diseases.

Anthocyanins: From Sources and Bioavailability to Cardiovascular-Health Benefits and Molecular Mechanisms of Action

Anthocyanins are phytochemicals widely found in plant foods, with berries and fruit-derived beverages as the main dietary sources. Accumulating evidence suggests the positive role of anthocyanins in preserving cardiovascular health. Epidemiological data show an association between anthocyanin intake and lower risk of myocardial infarction and cardiovascular-disease-related mortality. Clinical studies report the beneficial effects of the consumption of different anthocyanin-rich sources on surrogate markers of cardiovascular risk. Animal and in vitro evidence suggest the protective role of anthocyanins in dysfunctions related to the development of cardiovascular diseases. Still, the underlying molecular mechanisms of anthocyanin action seem complex and are not entirely clear. This review aims to give a comprehensive update on anthocyanins and their cardioprotective properties. It provides information on their sources; quantities consumed through diet; absorption; bioavailability; cardiovascular properties; and underlying mechanisms of action, including their effects on gene and protein expression and their interactions with cell-signaling pathways and miRNAs.

Nutrition and Cardiovascular Health

Cardiovascular disease (CVD) is the leading cause of death in Western countries, representing almost 30% of all deaths worldwide. Evidence shows the effectiveness of healthy dietary patterns and lifestyles for the prevention of CVD. Furthermore, the rising incidence of CVD over the last 25 years has become a public health priority, especially the prevention of CVD (or cardiovascular events) through lifestyle interventions. Current scientific evidence shows that Western dietary patterns compared to healthier dietary patterns, such as the ‘Mediterranean diet’ (MeDiet), leads to an excessive production of proinflammatory cytokines associated with a reduced synthesis of anti-inflammatory cytokines. In fact, dietary intervention allows better combination of multiple foods and nutrients. Therefore, a healthy dietary pattern shows a greater magnitude of beneficial effects than the potential effects of a single nutrient supplementation. This review aims to identify potential targets (food patterns, single foods, or individual nutrients) for preventing CVD and quantifies the magnitude of the beneficial effects observed. On the other hand, we analyze the possible mechanisms implicated in this cardioprotective effect.

Influence of Bioactive Nutrients on the Atherosclerotic Process: A Review

The protective effects of a dietary intervention as a useful tool in the prevention of atherosclerosis disease has gained greater attention in recent years. Several epidemiological studies have demonstrated the importance of diet in reducing expensive treatments or possible undesirable side effects. The main aim of this review is to examine the effects of specific nutrients on the development and progression of atherosclerosis in patients with cardiovascular disease. Various mechanisms have been proposed to explain the cardioprotective effect of different nutrients. In this sense, results have shown stabilization of vulnerable atherosclerotic plaques or downregulation of biomarkers related to inflammation through nutrients such as Omega-3 polyunsaturated fatty acids, hydroxytyrosol of extra virgin olive oil, lycopen, phytosterols of plants, or flavonols of fruits and vegetables, among others. The accumulated evidence on the anti-inflammatory effects related to these nutrients is summarized in the present review.

Blackberry and Blueberry Anthocyanin Supplementation Counteract High-Fat-Diet-Induced Obesity by Alleviating Oxidative Stress and Inflammation and Accelerating Energy Expenditure

Many studies indicate that an anthocyanin-rich diet has beneficial effects preventing metabolic disease. In the present study, the molecular mechanism underlying the antiobesity effect of consuming blackberry anthocyanins (BLA) and blueberry anthocyanins (BBA) was investigated in high-fat-diet- (HFD-) fed C57BL/6 mice. Sixty mice were administered a low-fat diet (LFD), a HFD, or a HFD plus orlistat, and BLA or BBA in their daily food for 12 weeks. As a result, the consumption of BLA and BBA inhibited body weight gain by 40.5% and 55.4%, respectively, in HFD-fed mice. The BLA and BBA treatments markedly reduced serum and hepatic lipid levels and significantly increased hepatic superoxide dismutase and glutathione peroxidase activities. In addition, the treatments effectively increased fecal acetate and butyrate levels and significantly attenuated expression of tumor necrosis factor TNF-α, interleukin-6, and nuclear factor-kappaB genes. Moreover, gas chromatography time-of-flight mass spectroscopy results suggested that BLA and BBA significantly affected the hepatic lipid and glucose metabolic pathways, including glycerophospholipid metabolism, glutathione metabolism, and the insulin-signaling pathway. Therefore, BLA and BBA ameliorated diet-induced obesity by alleviating oxidative stress and inflammation and accelerating energy expenditure.

Effect of anthocyanin supplementation on cardio-metabolic biomarkers: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Several studies have shown effects of anthocyanin on blood pressure, blood glucose, and lipid profile in different conditions, but the results of these studies are controversial. We summarized evidence from randomized clinical trials (RCTs) that investigated the effects of anthocyanin supplementation on cardio-metabolic biomarkers in adults.

METHODS

The literature searches of MEDLINE and EMBASE for published studies in English was performed up to August 2017. Results were summarized as mean differences (MD) with 95% confidence intervals (CI). Effect sizes of eligible studies were pooled using random-effects models (the DerSimonian-Laird estimator). Heterogeneity among studies was evaluated by the Cochrane Q test.

RESULTS

Of 5370 papers, 19 RCTs met inclusion criteria. There was no significant effect of anthocyanin supplementation on weight, waist circumference (WC), body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP). Our results indicated that anthocyanin supplementation had no significant effects on HbA1c (MD: -0.32; 95% CI = -0.64, 0.00; p = 0.050) with no heterogeneity (I² = 0.0%, p = 0.966, no significant heterogeneity), however anthocyanin supplementation had significant effect on HOMA-IR (MD: -0.21; 95% CI = -0.36, -0.07; p = 0.004) (I² = 37.9%, p = 0.200, no significant heterogeneity) in adults. Intake of anthocyanin had no significant effects on FBS (MD: 0.25; 95% CI = -5.70, 6.21; p = 0.933) and serum insulin (MD: 0.09; 95% CI = -0.92, 1.11; p = 0.860) with high heterogeneity for these variables (p = 0.000, and I² = 83.5%) and (p = 0.098, and I² = 52.4%), respectively. Anthocyanin supplementation had significant effects on total cholesterol (TC) and low density lipoprotein (LDL) for more than 300 mg/day intervention for more than 12 weeks. The dose and duration of supplementation were the potential sources of heterogeneity among most of the trials.

CONCLUSION

The results demonstrate that supplementation with anthocyanin have beneficial effect on HOMA-IR in adults.

Flavanols are potential anti-obesity agents, a systematic review and meta-analysis of controlled clinical trials

BACKGROUND

The anti-obesity potential of flavonoids has been shown by animal and human studies. In this meta-analysis, we systematically reviewed controlled clinical trials and quantified the effects of flavonoids and flavonoid subclasses on obesity-related anthropometric measures.

METHODS AND RESULTS

PubMed, EMBASE, Scopus, Web of Science, and ProQuest databases were searched to identify trials examining the effect of flavonoids on body mass index (BMI), waist circumference, and body fat percentage. Fifty eight trials passed the eligibility process. Analysis endpoints were calculated as the mean difference between baseline and post-treatment. Flavonoids were in subclasses of flavanols, flavonols, isoflavones, flavanones, anthocyanins, and proanthocyanidins. They were mostly in the form of supplements and dosages varying from 40 to 1300 mg/day. Among flavonoid subclasses, flavanols showed potential for decreasing BMI, in the overall population (mean difference (MD) = -0.28 kg/m², P = 0.04; n = 21) and in the subgroups of Asians (MD = -0.42 kg/m²; P = 0.046; n = 13), ages < 50 years (MD = -0.50 kg/m²; P = 0.008; n = 14), BMI ≥ 25 kg/m² (MD = -0.30 kg/m²; P = 0.049; n = 15), and at doses ≥ 500 mg/day (MD = -0.36 kg/m²; P = 0.049; n = 12). Isoflavones also decreased BMI of non-Asian populations (MD = -0.26 kg/m²; P = 0.035; n = 13) and doses ≥ 75 mg/day (MD = -0.34 kg/m²; P = 0.027; n = 8). In the overall assessment, flavanols also decreased waist circumference (MD = -0.60 cm; P = 0.02; n = 18) but had no significant effect on body fat percentage. The available trials did not reveal significant effects from flavonols, flavanones, and anthocyanins on the specified anthropometric measures.

CONCLUSIONS

Overall results of this meta-analysis showed that flavanols have potential against obesity.

Effect of Anthocyanin Supplementations on Lipid Profile and Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Purpose

To assess combined data from seventeen randomized controlled trials studying effect of anthocyanin consumption on levels of various lipids and inflammatory markers with meta-analysis approach.

Methods

Various databases, namely, PubMed, MEDLINE, EMBASE, and Cochrane Trial Register were used to identify randomized controlled trials (RCTs) investigating an association between anthocyanins and lipid profile and inflammatory markers. Heterogeneity was assessed using Q and I² statistics and data was expressed using mean difference with 95% confidence interval.

Results

Statistically significant reduction in triglyceride [mean difference (MD) = −9.16, 95% CI: −14.02 to −4.31 mg/dL, I² = 33.54%, P = 0.149], low density lipoprotein [MD = −8.86, 95% CI: −11.17 to −20.02 mg/dL, I² = 37.75%, P = 0.098], and apolipoprotein B [MD = −7.13, 95% CI: −8.66 to −5.59 mg/dL, I² = 20.42%, P = 0.287] levels and increase in high-density lipoprotein [MD = 1.67, 95% CI: 0.8 to 2.54 mg/dL, I² = 44.88%, P = 0.053] and apolipoprotein A-1 [MD = 6.1, 95% CI: 4.51 to 7.69 mg/dL, I² = 6.95%, P = 0.358] levels were observed with anthocyanin supplementation. Levels of inflammatory markers were found to reduce [TNF-∞ - MD = −1.98, 95% CI: −2.40 to −1.55 pg/mL, I² = 0%, P = 0.975; IL-6 - MD = 1.17, 95% CI: 0.8 to 1.53 pg/mL, I² = 0%, P = 0.825; hs-CRP - MD = 0.164, 95% CI: −0.06 to 0.39 mg/dL, I² = 0%, P = 0.569]. Though the effect on TC, IL-6, and hs-CRP was positive, it was nonsignificant in nature.

Conclusion

Anthocyanin supplementation significantly improves lipid profile and inflammatory status. However, future trials with sufficient sample size are recommended to substantiate the findings especially for the parameters showing nonsignificant improvement.

Effects of anthocyanins and their gut metabolites on adenosine diphosphate-induced platelet activation and their aggregation with monocytes and neutrophils

Accumulating evidence suggests that anthocyanins play an important role in the cardioprotective effects associated with consumption of anthocyanin-rich foods. These benefits may partly be attributed to their effects on platelets, significant contributors to cardiovascular disease development. This study aimed to investigate the impact of physiologically relevant concentrations of anthocyanins and their metabolites on platelet activation and platelet-leukocyte aggregation. Whole blood from seven healthy volunteers was treated with anthocyanins: cyanidin-3-arabinoside, cyanidin-3-glucoside, cyanidin-3-galactoside, delphinidin-3-glucoside and peonidin-3-glucoside at 0.1 μM concentration or gut metabolites: 4-hydroxybenzaldehyde, protocatechuic, vanillic, ferulic and hippuric acids at 0.5 μM, 0.2 μM, 2 μM, 1 μM, 2 μM concentration, respectively. Markers of adenosine diphosphate-induced platelet activation (P-selectin and GPIIb-IIIa expression) and platelet-monocyte and platelet-neutrophil aggregation were analyzed using flow cytometry. Cyanidin-3-arabinoside, delphinidin-3-glucoside, and peonidin-3-glucoside decreased agonist-induced P-selectin expression, while cyanidin-3-galactoside and cyanidin-3-arabinoside reduced platelet-neutrophil aggregation. Hippuric and protocatechuic acids inhibited P-selectin expression, ferulic acid reduced platelet-monocyte aggregation, while 4-hydroxybenzaldehyde affected P-selectin expression, platelet-neutrophil and monocyte aggregation. Only cyanidin-3-glucoside and protocatechuic acid decreased GPIIb-IIIa expression. These results demonstrate the bioactivity of anthocyanins and their gut metabolites at physiologically relevant concentrations on platelet function and interaction with leukocytes, presenting mechanisms by which they contribute to the beneficial effects of habitual consumption of anthocyanin-rich foods on cardiovascular health.