Effects of Montmorency Tart Cherry and Blueberry Juice on Cardiometabolic Outcomes in Healthy Individuals: Protocol for a 3-Arm Placebo Randomized Controlled Trial

Most UK cardiovascular disease trial protocols feature criteria that exclude ethnic minority participants: a systematic review

OBJECTIVES

We systematically reviewed UK cardiovascular disease (CVD) randomized controlled trial (RCT) protocols to identify the proportion featuring eligibility criteria that may disproportionately exclude ethnic minority (EM) participants.

METHODS

We searched MEDLINE, Embase, and Cochrane Library databases, January 2014-June 2022, to identify UK CVD RCT protocols. We extracted nonclinical eligibility criteria from trial protocols and inductively categorized the trials by their language, consent, and broad (ambiguous) criteria. Findings are narratively reported.

RESULTS

Of the seventy included RCT protocols, most (87.1%; 61/70) mentioned consent within the eligibility criteria, with more than two-thirds (68.9%; 42/61) indicating a requirement for 'written' consent. Alternative consent pathways that can aid EM participation were absent. English language requirement was present in 22.9% (16/70) of the studies and 37.1% (26/70) featured broad criteria that are open to interpretation and subject to recruiter bias. Only 4.3% (3/70) protocols mentioned the provision of translation services.

CONCLUSION

Most UK CVD trial protocols feature eligibility criteria that potentially exclude EM groups. Trial eligibility criteria must be situated within a larger inclusive recruitment framework, where ethnicity is considered alongside other intersecting and disadvantaging identities.

Effects of Montmorency Tart Cherry and Blueberry Juice on Cardiometabolic and Other Health-Related Outcomes: A Three-Arm Placebo Randomized Controlled Trial

The current study aimed to investigate the influence of tart cherry and blueberry juices on cardiometabolic and other health indices following a 20-day supplementation period. Forty-five adults were randomly assigned to receive tart cherry, blueberry, or a placebo, of which they drank 60 mL per day for 20 days. The primary outcome, which was systolic blood pressure, and secondary measures, including anthropometric, energy expenditure, substrate oxidation, hematological, diastolic blood pressure/resting heart rate, psychological wellbeing, and sleep efficacy, were measured before and after the intervention. There were no statistically significant differences (p > 0.05) for systolic blood pressure; however, total and LDL cholesterol were significantly improved with blueberry intake (pre: total cholesterol = 4.36 mmol/L and LDL cholesterol = 2.71 mmol/L; post: total cholesterol = 3.79 mmol/L and LDL cholesterol = 2.23 mmol/L) compared to placebo (pre: total cholesterol = 4.01 mmol/L and LDL cholesterol = 2.45 mmol/L; post: total cholesterol = 4.34 mmol/L and LDL cholesterol = 2.67 mmol/L). Furthermore, psychological wellbeing indices measured using the Beck Depression Inventory, State Trait Anxiety Inventory, and COOP WONCA improved statistically in the blueberry arm compared to placebo. Given the clear association between lipid concentrations and the risk of cardiovascular disease as well as the importance of psychological wellbeing to health-related quality of life, this investigation indicates that it could be an effective approach to assist in managing cardiometabolic disease.

Perceptions, beliefs and behaviors of nutritional and supplementary practices in inflammatory bowel disease

Purpose

To gain insight into the behaviors, perceptions and beliefs of inflammatory bowel disease (IBD) patients nutritional and supplementary practices and also to explore perceptions and behaviors in relation to anti-inflammatory supplementation with specific emphasis on Montmorency tart cherries.

Methods

80 IBD patients completed a 16-item close-ended questionnaire which was divided into three sub-sections: baseline/demographic characteristics, disease characteristics and dietary and supplementary perceptions, beliefs and behaviors. One-sample chi-square goodness of fit tests were used for each question and two-way Pearson chi-square tests of independence were used to undertake bivariate cross-tabulation comparisons to test differences in responses to each question between baseline/demographic variables.

Results

The majority of participants (N = 40) did not follow a specific dietary pattern or use supplements (N = 56). Respondents also predominantly rated that diet can both positively (N = 66) and negatively (N = 68) influence IBD. In addition, participants rated that supplements can positively influence IBD (N = 65) and that lack of scientific evidence was the primary mechanism preventing them from utilizing supplements (N = 34). Finally, patients also strongly reported that they would be willing to take Montmorency tart cherry supplementation (N = 73).

Conclusions

The disconnect between behavior and beliefs in both diet and supplementary practices, indicate that interventions designed to translate beliefs/knowledge into behaviors are warranted. There is also a necessity to undertake well-designed intervention trials examining the efficacy of food supplements, and with patient’s willingness to take Montmorency tart cherry, there is a strong rationale for future randomized trials examining the efficacy of tart cherry supplementation in IBD.