Strawberry Consumption, Cardiometabolic Risk Factors, and Vascular Function: A Randomized Controlled Trial in Adults with Moderate Hypercholesterolemia

Gut microbes metabolize strawberry phytochemicals and mediate their beneficial effects on vascular inflammation

Evidence suggests that a healthy gut microbiome is essential for metabolizing dietary phytochemicals. However, the microbiome's role in metabolite production and the influence of gut dysbiosis on this process remain unclear. Further, studies on the relationship among gut microbes, metabolites, and biological activities of phytochemicals are limited. We addressed this knowledge gap using strawberry phytochemicals as a model. C57BL/6J mice were fed a standard diet [C]; strawberry-supplemented diet (~2 human servings) [CS]; strawberry-supplemented diet and treated with antibiotics (to deplete gut microbes) [CSA]; high-fat diet (HFD) [HF]; strawberry-supplemented HFD [HS]; and strawberry-supplemented HFD and treated with antibiotics [HSA] for 12 weeks. First, antibiotic treatment suppressed the production of selected metabolites (CSA vs. CS), and p-coumaric acid was identified as a strawberry-derived microbial metabolite. Second, HFD-induced dysbiosis negatively affected metabolite production (HS vs. HF), and hippuric acid was identified as a microbial metabolite in HFD conditions. Third, dietary strawberries improved HFD-induced vascular inflammation (HS vs. HF). However, antibiotic treatment reduced metabolite production and abolished the vascular effects of strawberries (HSA vs. HS), indicating the importance of gut microbes in mediating the vascular benefits of strawberries via metabolites. Fourth, strawberry supplementation decreased Coprobacillus that was positively associated with vascular inflammation, whereas it increased Lachnospiraceae that was negatively associated with vascular inflammation and positively associated with hippuric acid. Fifth, hippuric acid was negatively associated with vascular inflammation. Our study fills in some pieces of the giant puzzle regarding the influence of gut microbes on the biological activities of phytochemicals. HFD-induced gut dysbiosis negatively impacts metabolite production and a strong association exists among gut microbes, strawberry-derived microbial metabolites, and the vascular benefits of dietary strawberries. Further, our study provides significant proof of concept to warrant future research on the use of strawberries as a nutritional strategy to prevent vascular complications.

Bioavailability and pharmacokinetics of (poly)phenols following consumption of selected blueberries and a blueberry-rich protein bar by adult males and females: a randomized, crossover, controlled trial

BACKGROUND

It is commonly believed that higher nutrient content equates to healthier foods and that food processing lowers nutrient content, although bioavailability studies often indicate otherwise. Blueberries, a rich source of (poly)phenols with proven health benefits, provide a feasible model to evaluate phytochemical bioavailability following consumption of raw and processed fruits.

OBJECTIVES

This study evaluates the effect of processing on the bioavailability of (poly)phenols following consumption of 4 interventions: 2 blueberry varieties (i.e., Elliott and Olympia) selected based on differing (poly)phenol content and in vitro bioaccessibility, a (poly)phenol-rich protein bar providing an equivalent amount of blueberries, and a control beverage.

METHODS

This blinded, randomized, 4-way crossover, controlled trial (n = 18; 42.06 ± 12.53 y; body mass index [BMI] 24.75 ± 2.97 kg/m2) fed 1 serving (150 g) of Elliott and Olympia blueberries and a (poly)phenol-rich protein bar containing 1 serving of Elliott blueberries, compared with a macronutrient-matched control beverage. (Poly)phenols and metabolites were analyzed in blood and urine over 48 h, with bioavailability and pharmacokinetics assessed via linear mixed-effects repeated measures ANOVA.

RESULTS

Recovery of metabolites was similar following consumption of blueberry varieties of differing (poly)phenol composition, with higher total urinary recovery after Elliott blueberry relative to Olympia blueberry and protein bar (21% and 29%, respectively). Serum AUC was similar across berry-derived treatments, whereas differences in maximum concentration (Cmax) and time at maximum concentration (Tmax) were observed; for example, urinary recovery of 3-methoxycinnamic acid-4-O-glucuronide was similar following Elliott blueberry and protein bar (P = 1.00), whereas Cmax was 1.24 h later after Elliott blueberry compared with protein bar (Tmax = 3.84 compared with 2.60 h). Alternatively, Cmax for 3-(3-hydroxyphenyl)propanoic acid was higher following Elliott blueberry compared with Olympia blueberry and protein bar (26.63 and 25.32 ng/mL higher, respectively).

CONCLUSIONS

Differing berry (poly)phenol content and bioaccessibility only minimally affect bioavailability following consumption of blueberries relative to a blueberry-rich protein bar, suggesting (poly)phenol-dense foods, such as bars and snacks, could provide similar health benefits as raw fruits. Further studies using other crops are required to assess if these findings are translatable. This trial was registered at clinicaltrials.gov as NCT04175106.

Strawberries modestly improve cognition and cardiovascular health in older adults

BACKGROUND AND AIMS

Strawberry consumption may aid in improving cognitive function and cardiovascular health given their nutrient composition and antioxidant capacities. We hypothesized that 2 cups of fresh strawberries per day provided as a freeze-dried strawberry powder (26 g/d) may improve cognitive performance and cardiovascular health relative to a control.

METHODS AND RESULTS

Using a randomized, crossover, double-blind, placebo-controlled clinical trial, 35 healthy older adults (17 women, 18 men, age 72 ± 6 years, BMI 26.4 ± 3.9 kg/m2) consumed 26 g of freeze-dried strawberry powder (strawberry) and a control powder (control) daily for 8 weeks each with a 4-week washout period. Strawberry supplementation was expected to improve cardiometabolic health parameters, and cognitive performance measured with the National Institutes of Health Toolbox. Processing speed (p < 0.001) improved during the strawberry phase and episodic memory (p = 0.002) improved during the control phase. For cardiovascular measures, strawberry consumption reduced systolic blood pressure (p = 0.044) and a significant main effect of time for reduced waist circumference (p = 0.043) was detected. Serum triglycerides increased in the control group (p = 0.012) but not after consuming strawberries. Total antioxidant capacity significantly decreased during the control phase (p = 0.032) and significantly increased with strawberry consumption (p = 0.047).

CONCLUSION

This study demonstrated that 26 g of freeze dried strawberries improve cognitive processing speed, lower systolic blood pressure, and increase antioxidant capacity, potentially promoting cognitive function and improving cardiovascular risk factors in cognitively healthy individuals.

CLINICAL TRIAL REGISTRY

NCT04786665.

The long-term and post-prandial effects of berry consumption on endothelial dysfunction in adults: a systematic review and meta-analysis of randomised controlled trials

This systematic review and meta-analysis evaluated the long-term and post-prandial effects of berry consumption on endothelial dysfunction (ED) in adults. To identify relevant randomised controlled trials (RCTs), a systematic search was run and studies that examined the effects of berries consumption on ED markers were included. A total of 45 RCTs were included, focusing on markers such as flow-mediated dilation (FMD), pulse wave velocity (PWV), augmentation index (AIx), reactive hyperaemia index (RHI) and total peripheral resistance (TPR). The meta-analysis revealed that long-term berry consumption significantly increased FMD and decreased PWV. However, no significant effects were found for AIx, RHI or TPR. In post-prandial studies, berry consumption also improved FMD, but had no significant impact on PWV, AIx or RHI. Overall, berries were found to benefit endothelial function, particularly in improving FMD, though the effects on other cardiovascular markers were less consistent. Factors like trial design and berry type influenced outcomes.

Phenolic Metabolites Protocatechuic Acid and Vanillic Acid Improve Nitric Oxide Bioavailability via the Akt-eNOS Pathway in Response to TNF-α Induced Oxidative Stress and Inflammation in Endothelial Cells

Background/Objectives: Reduced nitric oxide (NO) bioavailability secondary to excess-superoxide-driven oxidative stress is central to endothelial dysfunction. Previous studies suggest that phenolic metabolites may improve NO bioavailability, yet limited research is available in response to an inflammatory mediator. Therefore, we assessed the effects of cyanidin-3-glucoside (C3G) and its phenolic metabolites protocatechuic acid (PCA) and vanillic acid (VA) on NO bioavailability in a TNF-α induced inflammatory environment. Methods: Primary human umbilical vein endothelial cells (HUVECs) were supplemented with either C3G, PCA, or VA at 1 μM for 24 h before being stimulated with TNF-α 20 ng/mL for an additional 24 h. Measurements included cell viability, apoptosis, reactive oxygen species (ROS), nitrite concentrations, and endothelial nitric oxide synthase (eNOS) and Akt at the mRNA and protein level. Results: Phenolic metabolites did not increase the eNOS expression or nitrite levels in the unstimulated environment; rather, the metabolites mediated NO bioavailability in response to TNF-α induced oxidative stress, with increased viability, eNOS mRNA, phosphorylation, and nitrite levels. Conclusions: Phenolic metabolites, in the presence of TNF-α, can improve NO bioavailability at physiologically relevant concentrations via the Akt-eNOS pathway. This demonstrates that the induction of inflammation is a prerequisite for phenolic metabolites to promote protective properties in endothelial cells by activating the Akt-eNOS pathway.

The Effect of Black Chokeberry (Aronia melanocarpa) on Human Inflammation Biomarkers and Antioxidant Enzymes: A Systematic Review of Randomized Controlled Trials

CONTEXT

Consuming antioxidant-rich foods has been associated with potential benefits in managing chronic diseases by reducing oxidative stress and inflammation.

OBJECTIVE

This systematic review aimed to evaluate the effects of Aronia melanocarpa (aronia berry or chokeberry) on human inflammation biomarkers and antioxidant enzymes.

DATA SOURCES

A systematic search was conducted across multiple databases, including PubMed, Scopus, Science Direct, and Web of Science, to identify relevant studies investigating the potential effects of aronia on human inflammation biomarkers and antioxidant enzymes between April 2022 and November 2023.

DATA EXTRACTION

The selection of studies followed the PRISMA guidelines, data screening was conducted by 4 independent reviewers, and data extraction and risk-of-bias assessments were performed by 2 independent reviewers using the Cochrane Risk of Bias 2 tool.

DATA ANALYSIS

A total of 1986 studies were screened, and 18 studies that met the inclusion criteria were included in a systematic review that investigated the anti-inflammatory effects of aronia on various health parameters. These studies primarily focused on the effects of aronia on cardiometabolic diseases, performance in sport, and other health parameters.

CONCLUSIONS

This study examined the effects of Aronia intervention on human health outcomes using aronia juice, extract, or oven-dried powder for a period of 4 to 13 weeks. The primary health parameters considered were C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), interleukin-8 (IL-8), interleukin-10 (IL-10), interleukin-1ß (IL-1ß), superoxide dismutase (SOD), catalase (CAT), and reduced glutathione peroxidase (GSH-Px). The results showed that aronia had a beneficial effect on several inflammatory cytokines, including reductions in CRP, TNF-α and IL-6 concentrations, as well as elevated IL-10 levels. Moreover, positive changes have been observed in antioxidant enzyme systems, including; elevated SOD, GSH-Px and CAT activity. The findings of the presented studies provide evidence that Aronia melanocarpa may have beneficial effects on inflammatory markers.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration No. CRD42022325633.

Synergistic Effects of Turmeric, Strawberry and Broccoli in Improving Lipid Profile in Adult Patients with Hypercholesterolemia

<b>Background and Objective:</b> Turmeric, strawberries and broccoli are popular in the community for their beneficial effects in improving lipid profile, but poor bioavailability and absorption of their phytochemical compounds might reduce their effects while given separately. Therefore, their combination might provide a synergistic enhancement of their property as hypolipidemic agents. This study aims to examine the effects of turmeric, strawberry and broccoli in improving lipid profile in adult patients with hypercholesterolemia. <b>Materials and Methods:</b> Twenty hypercholesterolemic adult patients from Unggul Karsa Medika Hospital in Bandung, Indonesia were recruited for the study, they were given 600 mg/day of turmeric/curcuminoid, 100 g of fresh strawberry and 100 g of boiled broccoli for 30 days. The measurement of the patient's characteristics (body weight, height, BMI) and biochemical parameters in the blood (total cholesterol, triglyceride, LDL-C, HDL-C, SGOT, SGPT, urea and creatinine) were conducted before and after the treatment. <b>Results:</b> The mean age of the patients was 49.15±1.9 years old, with mean height 1.56±0.014 m, weight 61.43±1.96 kg and mean body mass index 25.25±0.87 kg/m^{<a href="86677_op">2</a>}. Lipid profile before the treatment: Total cholesterol 239.75±6.56 mg/dL, LDL-C 172.9±6.53 mg/dL, HDL-C 66.55±3.37 mg/dL and triglyceride 193.7±18.45 mg/dL; after the treatment: Total cholesterol 220.7±9.39 mg/dL, LDL-C 153.95±9.98 mg/dL, HDL-C 59.2±2.45 mg/dL and triglyceride 145±16.55 mg/dL. The result showed a significant reduction of total cholesterol (p = 0.014), LDL-C (p = 0.036), HDL-C (p = 0.001) and triglyceride (p = 0.015) after the treatment. Other biochemical parameters (SGOT, SGPT, urea and creatinine) showed normal levels before and after the treatment. <b>Conclusion:</b> In summary, supplementation of turmeric, strawberry and broccoli improves lipid profile in adult patients with hypercholesterolemia.

A critical examination of human data for the biological activity of phenolic acids and their phase-2 conjugates derived from dietary (poly)phenols, phenylalanine, tyrosine and catecholamines

Free or conjugated aromatic/phenolic acids arise from the diet, endogenous metabolism of catecholamines (adrenaline, noradrenaline, dopamine), protein (phenylalanine, tyrosine), pharmaceuticals (aspirin, metaprolol) plus gut microbiota metabolism of dietary (poly)phenols and undigested protein. Quantitative data obtained with authentic calibrants for 112 aromatic/phenolic acids including phase-2 conjugates in human plasma, urine, ileal fluid, feces and tissues have been collated and mean/median values compared with in vitro bioactivity data in cultured cells. Ca 30% of publications report bioactivity at ≤1 μmol/L. With support from clinical studies, it appears that the greatest benefit might be produced in vascular tissues by C6-C3 metabolites, including some of gut microbiota origin and some phase-2 conjugates, 15 of which are 3',4'-disubstituted with multiple sources including caffeic acid and hesperetin, plus one unsubstituted and two mono-substituted examples which can originate from protein. There is an unexamined potential for synergy. Free-living and washout plasma data are scarce. Some metabolites have been overlooked, notably phenyl-lactic, phenyl-hydracrylic and phenyl-propanoic acids, especially those from amino acids plus glycine, hydroxy-glycine and glutamine conjugates. Phenolic acids and conjugates from multiple sources exhibit biological activities, some of which are likely relevant in vivo and link to biomarkers of health. Further targeted studies are justified.

Strawberry (Fragaria x Ananassa) intake on human health and disease outcomes: a comprehensive literature review

Strawberries provide a number of potential health promoting phytonutrients to include phenolics, polyphenols, fiber, micronutrients and vitamins. The objective of this review is to provide a comprehensive summary of recent human studies pertaining to the intake of strawberry and strawberry phytonutrients on human health. A literature search conducted through PubMed and Cochrane databases consolidated studies focusing on the effects of strawberry intake on human health. Articles were reviewed considering pre-determined inclusion and exclusion criteria, including experimental or observational studies that focused on health outcomes, and utilized whole strawberries or freeze-dried strawberry powder (FDSP), published between 2000-2023. Of the 60 articles included in this review, 47 were clinical trials, while 13 were observational studies. A majority of these studies reported on the influence of strawberry intake on cardiometabolic outcomes. Study designs included those examining the influence of strawberry intake during the postprandial period, short-term trials randomized with a control, or a single arm intake period controlling with a low polyphenolic diet or no strawberry intake. A smaller proportion of studies included in this review examined the influence of strawberry intake on additional outcomes of aging including bone and brain health, and cancer risk. Data support that the inclusion of strawberries into the diet can have positive impacts during the postprandial period, with daily intake improving outcomes of lipid metabolism and inflammation in those at increased cardiovascular risk.

Effects of Polyphenol-Rich Foods on Lipids and Oxidative Stress Status in Patients with Hyperlipidemia: A Systematic Review of Randomized Controlled Trials

Background

Hyperlipidemia has been demonstrated to be an autonomous predictor of numerous cardiovascular and cerebrovascular ailments, and research indicates that polyphenols have preventive and therapeutic effects on hyperlipidemia. Nevertheless, the impact of polyphenol-rich foods on blood lipids and oxidative stress status in patients with hyperlipidemia remains inconclusive.

Objective

To examine the impact of polyphenol-rich foods on lipid levels and oxidative stress in individuals with hyperlipidemia.

Methods

To retrieve papers published from the establishment of the database through October 9, 2023, eight databases were searched: the Chinese National Knowledge Infrastructure, the China Biomedical Literature Database, the Wanfang Database, the China Science and Technology Journal Database, PubMed, the Cochrane Library, Embase, and the Web of Science. The quality of include studies was assessed using the Cochrane Risk of Bias in Randomized Trials tool, v2.

Results

The study involved 13 surveys encompassing 640 patients diagnosed with hyperlipidemia. The scope of the food surveys included 12 commonly consumed food groups and medicinal and food homologous substances. All 13 studies reported the effects of polyphenol-rich foods on blood lipids, with significant improvements observed in blood lipid levels for 9 types of foods. Eight studies examined the impact on oxidative stress, and six foods demonstrated a significant reduction in oxidative stress levels. The observed effects were found to be influenced by factors such as dosage, duration of intervention, and gender.

Conclusion

Foods abundant in polyphenols play a crucial role in the prevention and treatment of hyperlipidemia by counteracting oxidative stress and regulating metabolic disorders. The confirmation of certain positive effects by several studies notwithstanding, discrepancies in results arise from various factors, necessitating further large-scale, prospective, well-designed randomized controlled studies to address this issue.

Phenolic Compounds from Cherries and Berries for Chronic Disease Management and Cardiovascular Risk Reduction

Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Therefore, there is increasing interest in dietary interventions to reduce risk factors associated with these conditions. Cherries and berries are rich sources of bioactive compounds and have attracted attention for their potential cardiovascular benefits. This review summarises the current research on the effects of cherry and berry consumption on cardiovascular health, including in vivo studies and clinical trials. These red fruits are rich in phenolic compounds, such as anthocyanins and flavonoids, which have multiple bioactive properties. These properties include antioxidant, anti-inflammatory, and vasodilatory effects. Studies suggest that regular consumption of these fruits may reduce inflammation and oxidative stress, leading to lower blood pressure, improved lipid profiles, and enhanced endothelial function. However, interpreting findings and establishing optimal dosages is a challenge due to the variability in fruit composition, processing methods, and study design. Despite these limitations, the evidence highlights the potential of cherries and berries as components of preventive strategies against CVD. Further research is needed to maximise their health benefits and improve clinical practice.

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.

Resveratrol and beyond: The Effect of Natural Polyphenols on the Cardiovascular System: A Narrative Review

Cardiovascular diseases (CVDs) are among the leading causes of morbidity and mortality worldwide. Unhealthy dietary habits have clearly been shown to contribute to the development of CVDs. Beyond the primary nutrients, a healthy diet is also rich in plant-derived compounds. Natural polyphenols, found in fruits, vegetables, and red wine, have a clear role in improving cardiovascular health. In this review, we strive to summarize the results of the relevant pre-clinical and clinical trials that focused on some of the most important natural polyphenols, such as resveratrol and relevant flavonoids. In addition, we aim to identify their common sources, biosynthesis, and describe their mechanism of action including their regulatory effect on signal transduction pathways. Finally, we provide scientific evidence regarding the cardiovascular benefits of moderate, long-term red wine consumption.

Early Intervention in Cognitive Aging with Strawberry Supplementation

Late-life dementia is a growing public health concern lacking effective treatment. Neurodegenerative disorders such as Alzheimer's disease (AD) develop over a preclinical period of many years beginning in midlife. The prevalence of insulin resistance, a prominent risk factor for late-life dementia, also accelerates in middle-age. Consumption of berry fruits, including strawberries, has been shown to influence metabolism as well as cognitive performance suggesting potential to mitigate risk for dementia. In this controlled trial, we enrolled overweight middle-aged men and women with insulin resistance and subjective cognitive decline and performed a 12-week intervention with daily administration of whole-fruit strawberry powder. Diet records showed that participants in both groups maintained the prescribed abstinence from berry product consumption outside the study. We observed diminished memory interference (p = 0.02; Cohen's f = 0.45) and a reduction of depressive symptoms (p = 0.04; Cohen's f = 0.39) for the strawberry-treated participants; benefits consistent with improved executive ability. However, there was no effect of the intervention on metabolic measures, possibly a consequence of the sample size, length of the intervention, or comparatively low anthocyanin dose. Anti-inflammatory actions of anthocyanins were considered as a primary mechanistic factor. The findings support the notion that strawberry supplementation has a role in dementia risk reduction when introduced in midlife. However, further investigation with longer intervention periods, larger samples, and differing dosing regimens will be required to assess the benefits of strawberry intake with respect to cognition and metabolic function in the context of aging.

Perspective: Challenges and Future Directions in Clinical Research with Nuts and Berries

Consumption of nuts and berries are considered part of a healthy eating pattern. Nuts and berries contain a complex nutrient profile consisting of essential vitamins and minerals, fiber, polyunsaturated fatty acids, and phenolics in quantities that improve physiological outcomes. The spectrum of health outcomes that may be impacted by the consumptions of nuts and berries includes cardiovascular, gut microbiome, and cognitive, among others. Recently, new insights regarding the bioactive compounds found in both nuts and berries have reinforced their role for use in precision nutrition efforts. However, challenges exist that can affect the generalizability of outcomes from clinical studies, including inconsistency in study designs, homogeneity of test populations, variability in test products and control foods, and assessing realistic portion sizes. Future research centered on precision nutrition and multi-omics technologies will yield new insights. These and other topics such as funding streams and perceived risk-of-bias were explored at an international nutrition conference focused on the role of nuts and berries in clinical nutrition. Successes, challenges, and future directions with these foods are presented here.

Polyphenolic profiles of a variety of wild berries from the Pacific Northwest region of North America

Polyphenols have been extensively profiled and quantified in commercially grown berries, but similar information is sparsely available for wild berries. Because polyphenolic contents are inherently associated with berries health benefits, determining phenolic profiles is an important step for strategizing potential uses by the industry and for health and nutrition outcomes. Here, we profiled phenolic compounds in wild berries commonly encountered and harvested in the Pacific Northwest region of North America. Huckleberries (Vaccinium membranaceum) of varying phenotypes were found to be comparable to related blueberries in terms of general phenolic classes composition. However, all huckleberries exhibited markedly high levels of cyanidins, and delphinidins or peonidins were also higher in specific phenotypes. Wild black elderberries (Sambucus nigra spp. Canadensis) were found to have remarkably high phenolic, especially anthocyanins, in line with reports from cultivated elderberries. Saskatoon serviceberries (Amelanchier alnifolia) were found to exhibit high polyphenol content, but with a less diverse profile dominated by quercetin. The most intriguing berry may be the Oregon grape (Mahonia Aquifolium) being the only one exhibiting more than one g of polyphenols per 100 g; as well as a remarkably even distribution of the different anthocyanin classes. All colored wild berries were found to have at minimum comparable total phenolic contents when compared to cultivated and other wild berries, suggesting they should exhibit comparable human health benefits such as antioxidant and metabolic syndrome preventative potential described for these other berries. Overall, our data represents a valuable resource to explore the potential to valorize wild berry species for their specific phenolic profiles and predicted nutritional and health properties. With repeated phenolic profiling to better understand the impact of the environment, the wild berries described here hold promises both as food ingredient applications as well as valuable complement for healthy dietary patterns.

Biomarkers of Berry Intake: Systematic Review Update

Berries are rich in (poly)phenols, and these compounds may be beneficial to human health. Estimating berry consumption through self-reported questionnaires has been challenging due to compliance issues and a lack of precision. Estimation via food-derived biomarkers in biofluids was proposed as a complementary alternative. We aimed to review and update the existing evidence on biomarkers of intake for six different types of berries. A systematic literature search was performed to update a previous systematic review on PubMed, Web of Science, and Scopus from January 2020 until December 2022. Out of 42 papers, only 18 studies were eligible. A multimetabolite panel is suggested for blueberry and cranberry intake. Proposed biomarkers for blueberries include hippuric acid and malvidin glycosides. For cranberries, suggested biomarkers are glycosides of peonidin and cyanidin together with sulfate and glucuronide conjugates of phenyl-γ-valerolactone derivatives. No new metabolite candidates have been found for raspberries, strawberries, blackcurrants, and blackberries. Further studies are encouraged to validate these multimetabolite panels for improving the estimation of berry consumption.

Elderberry extract improves molecular markers of endothelial dysfunction linked to atherosclerosis

Endothelial dysfunction (ED), secondary to diminished nitric oxide (NO) production and oxidative stress, is an early subclinical marker of atherosclerosis. Reduced NO bioavailability enhances the adhesion of monocytes to endothelial cells and promotes atherosclerosis. Elderberry extract (EB) is known to contain high levels of anthocyanins which could exert vascular protective effects. Specifically, we investigated the functional capacity of EB on various markers of ED. Human umbilical vein endothelial cells (HUVEC) were pretreated with EB 50 μg/mL and stimulated with TNF-α 10 ng/mL. Cell viability, apoptosis, oxidative stress; eNOS, Akt, Nrf2, NOX-4, and NF-κB at the protein level were measured. A co-culture model was used to determine whether EB could prevent the adhesion of monocytes (THP-1) to HUVECs. Moreover, the expression of adhesion molecules and pro-inflammatory cytokines were also measured. It was demonstrated that EB prevented TNF-α induced apoptosis and reactive oxygen species production in HUVECs. Additionally, EB upregulated Akt and eNOS activity, and Nrf2 expression in response to TNF-α, whereas it decreased NOX-4 expression and NF-κB activity. EB prevented the adhesion of monocytes to HUVECs, as well as reduced IL-6 and MCP-1 levels, which was associated with inhibition of VCAM-1 expression. Our results demonstrate that EB upregulates key cellular markers of endothelial function and ameliorates markers of ED. EB could be used as a potential nutritional aid for preventing atherosclerosis progression.

Anthocyanins and Vascular Health: A Matter of Metabolites

Anthocyanins are a subgroup of flavonoid polyphenols previously investigated for improving cardiovascular health and preventing the development of endothelial dysfunction. However, their poor bioavailability raises the question of whether the observed biological activity is due to their metabolites. Phenolic metabolites can reach higher plasma concentrations and can persist in the circulation for periods much longer than their original anthocyanin form; therefore, the biological activity and health promoting effects of anthocyanins may differ from their metabolites. To address this, recent studies have facilitated different cell models, in vivo studies and explored physiologically relevant concentrations to better understand their mechanisms of action. The criteria were chosen based on previous reports demonstrating that anthocyanins can improve endothelial function via modulation of the Akt-endothelial nitric oxide synthase pathway and transcription factors Nrf2 and NF-κB, which made it critical to assess the phenolic metabolites' modes of action via these pathways. This review demonstrates how phenolic metabolites differ in bioactivity from their precursor anthocyanin, demonstrating improved endothelial function in response to inflammatory mediators at concentrations that are tolerated in vivo. The review highlights the crucial need for further studies to focus on improving the bioavailability of metabolites in isolation and explore the effect of metabolites in mixtures.

Dietary Sources of Anthocyanins and Their Association with Metabolome Biomarkers and Cardiometabolic Risk Factors in an Observational Study

Anthocyanins (ACNs) are (poly)phenols associated with reduced cardiometabolic risk. Associations between dietary intake, microbial metabolism, and cardiometabolic health benefits of ACNs have not been fully characterized. Our aims were to study the association between ACN intake, considering its dietary sources, and plasma metabolites, and to relate them with cardiometabolic risk factors in an observational study. A total of 1351 samples from 624 participants (55% female, mean age: 45 ± 12 years old) enrolled in the DCH-NG MAX study were studied using a targeted metabolomic analysis. Twenty-four-hour dietary recalls were used to collect dietary data at baseline, six, and twelve months. ACN content of foods was calculated using Phenol Explorer and foods were categorized into food groups. The median intake of total ACNs was 1.6mg/day. Using mixed graphical models, ACNs from different foods showed specific associations with plasma metabolome biomarkers. Combining these results with censored regression analysis, metabolites associated with ACNs intake were: salsolinol sulfate, 4-methylcatechol sulfate, linoleoyl carnitine, 3,4-dihydroxyphenylacetic acid, and one valerolactone. Salsolinol sulfate and 4-methylcatechol sulfate, both related to the intake of ACNs mainly from berries, were inversely associated with visceral adipose tissue. In conclusion, plasma metabolome biomarkers of dietary ACNs depended on the dietary source and some of them, such as salsolinol sulfate and 4-methylcatechol sulfate may link berry intake with cardiometabolic health benefits.

Ellagitannins, urolithins, and neuroprotection: Human evidence and the possible link to the gut microbiota

Ellagitannins (ETs) and ellagic acid (EA) are dietary polyphenols poorly absorbed but extensively metabolized by the human gut microbiota to produce different urolithins (Uros). Depending on the individuals' microbial signatures, ETs metabolism can yield the Uro metabotypes A, B, or 0, potentially impacting human health after consuming ETs. Human evidence points to improved brain health after consuming ET-rich foods, mainly pomegranate juices and extracts containing punicalagin, punicalin, and different EA-derivatives. Although ETs and (or) EA are necessary to exert the effects, the precise mechanism, actual metabolites, or final drivers responsible for the observed effects have not been unraveled. The cause-and-effect evidence on Uro-A administration and the improvement of animal brain health is consistent but not addressed in humans. The Uro-A's in vivo anti-inflammatory, mitophagy, autophagy, and mitochondrial biogenesis activities suggest it as a possible final driver in neuroprotection. However, the precise Uro metabolic forms reaching the brain are unknown. In addition to the possible participation of direct effectors in brain tissues, the current evidence points out that improving blood flow, gut microbiota ecology, and gut barrier by ET-rich foods and (or) Uro-A could contribute to the neuroprotective effects. We show here the current human evidence on ETs and brain health, the possible link between the gut microbiota metabolism of ETs and their effects, including the preservation of the gut barrier integrity, and the possible role of Uros. Finally, we propose a roadmap to address what is missing on ETs, Uros, and neuroprotection.

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

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

The Role of Berry Consumption on Blood Pressure Regulation and Hypertension: An Overview of the Clinical Evidence

The existence of a relationship between the consumption of dietary berries and blood pressure reduction in humans has been repeatedly hypothesized and documented by an increasing body of epidemiological and clinical evidence that has accumulated in recent years. However, results are mixed and complicated by a number of potentially confounding factors. The objective of this article is to review and summarize the available clinical evidence examining the effects of berry consumption on blood pressure regulation as well as the prevention or treatment of hypertension in humans, providing an overview of the potential contribution of distinctive berry polyphenols (anthocyanins, condensed tannins and ellagic acid), and results of dietary interventions with blueberries, bilberries, cranberries, raspberries, strawberries, chokeberries, cherries, blackcurrants and açai berries. We conclude that, while there is insufficient evidence supporting the existence of a direct blood pressure lowering effect, there is stronger evidence for specific types of berries acting indirectly to normalize blood pressure in subjects that are already hypertensive.