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Roy A, Goetz ME, Gebretsadik T, Kocak M, Adgent M, Zhao Q, Carroll KN, Hartman TJ. Maternal dietary flavonoid intake and child wheeze and asthma in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort. Pediatr Allergy Immunol 2025; 36:e70052. [PMID: 40087909 PMCID: PMC12040497 DOI: 10.1111/pai.70052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 02/10/2025] [Accepted: 02/24/2025] [Indexed: 03/17/2025]
Abstract
BACKGROUND Higher intakes of flavonoids have been associated with better lung function in adults. The aim of this study was to examine the associations between maternal prenatal intake of flavonoids and offspring asthma and wheeze. METHODS We conducted a prospective study of Black (62.8%) and White (37.2%) mother-child dyads (N = 906) enrolled in the CANDLE study. We estimated prenatal dietary flavonoid intake using the Block Food Frequency Questionnaire administered during the second trimester and subsequently linked to the United States Department of Agriculture's Provisional Flavonoid Addendum and Proanthocyanidin database. Our primary outcomes included parent report of child current wheeze and asthma (based on diagnosis, symptoms, and/or medication use) at approximately age 4 years. We used multivariable logistic regression to investigate associations between prenatal flavonoid intake and child respiratory outcomes. RESULTS Overall, 19.4% and 15.8% of children had current wheeze and asthma, respectively. The highest quartile of prenatal dietary total flavonoid was associated with lower odds of childhood respiratory outcomes, relative to the lowest quartile, for current wheeze (adjusted odds ratios (aOR) [95% confidence intervals (CI)]: 0.58 [0.35, 0.96]) and current asthma (aOR [95% CI]: 0.53 [0.31, 0.91]), respectively, although there was not a clear dose-response. We observed an inverse association between the prenatal intake of proanthocyanidin and offspring current asthma, but no associations for other flavonoid subclasses. CONCLUSIONS We report a novel finding that children of women with the highest compared to the lowest prenatal intake of total dietary flavonoids had lower odds of current wheeze and asthma at age 4 years.
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Affiliation(s)
- Aditi Roy
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Centre for Chronic Disease Control, New Delhi, India
| | | | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
- Department of Biostatistics, Istanbul Medipol University, Istanbul, Turkey
| | - Margaret Adgent
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Kecia N. Carroll
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of General Pediatrics, Departments of Pediatrics and Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Abstract
Diets and dietary constituents that we consume have a considerable impact on disease risk. Intriguingly these effects may be modulated to some extent by sex. Lack of female representation in nutritional studies as well as a lack of stratification by sex has and continues to limit our understanding of these sex × diet interactions. Here we provide an overview of the current and available literature describing how exposure to certain dietary patterns (Western-style diet, Mediterranean diet, vegetarian/vegan, ketogenic diet) and dietary constituents (dietary fibre, PUFA and plant bioactive) influences disease risk in a sex-specific manner. Interestingly, these sex differences appear to be highly disease-specific. The identification of such sex differences in response to diet stresses the importance of sex stratification in nutritional research.
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Affiliation(s)
| | - David Vauzour
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Michael Muller
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
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Zhuo S, Zhang B, Zhang J, Yang M, Yu Z. Effects of dietary inflammatory index, blood lead levels, and flavonoid intake on stroke risk in older Americans: A cross-sectional study. J Stroke Cerebrovasc Dis 2023; 32:107336. [PMID: 37677899 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107336] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES We aimed to investigate the relationship between dietary flavonoids, the dietary inflammatory index (DII), blood lead levels, and stroke and evaluate how these factors interact with one another in relation to stroke. MATERIALS AND METHODS We analyzed data from 3675 older American adults aged ≥60 years, obtained from the National Health and Nutrition Examination Survey. Since this database does not specifically differentiate between hemorrhagic and ischemic strokes, our data include both types. We utilized the DII to assess the inflammatory potential of the diet, calculated using 24 h dietary recalls. To determine the association between dietary flavonoids, blood lead levels, DII, and stroke, we performed multivariate logistic regression, subgroup analysis, and restricted cubic splines. We modeled additive interactions to assess the relationship between blood lead levels and DII. RESULTS A high intake of flavonols, flavan-3-ols, and total flavonoids correlated negatively with stroke risk, whereas blood lead levels had a positive association. After adjusting for confounders, stroke risk was found to increase with higher DII. Restricted cubic splines analysis revealed that flavan-3-ols, total flavonoids, blood lead levels, and DII were linearly related to stroke, while the relationships with flavonoids and flavonols were nonlinear. Additionally, a significant interaction was detected between high DII and elevated blood lead levels in relation to stroke risk. CONCLUSIONS Intake of flavan-3-ol, flavanols, and total flavonoids is negatively associated with stroke risk, while higher blood lead levels and DII are positively related to it. High DII and elevated blood lead levels interact synergistically to influence stroke risk.
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Affiliation(s)
- Shitu Zhuo
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Biyue Zhang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Jingying Zhang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Meili Yang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Zheng Yu
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China.
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Shubina VS, Kozina VI, Shatalin YV. A Comparative Study of the Inhibitory Effect of Some Flavonoids and a Conjugate of Taxifolin with Glyoxylic Acid on the Oxidative Burst of Neutrophils. Int J Mol Sci 2023; 24:15068. [PMID: 37894747 PMCID: PMC10606308 DOI: 10.3390/ijms242015068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/30/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
During the storage, processing, and digestion of flavonoid-rich foods and beverages, a condensation of flavonoids with toxic carbonyl compounds occurs. The effect of the resulting products on cells remains largely unknown. The aim of the present study was to evaluate the effects of quercetin, taxifolin, catechin, eriodictyol, hesperetin, naringenin, and a condensation product of taxifolin with glyoxylic acid on the oxidative burst of neutrophils. It was found that the flavonoids and the condensation product inhibited the total production of ROS. Flavonoids decreased both the intra and extracellular ROS production. The condensation product had no effect on intracellular ROS production but effectively inhibited the extracellular production of ROS. Thus, the condensation of flavonoids with toxic carbonyl compounds may lead to the formation of compounds exhibiting potent inhibitory effects on the oxidative burst of neutrophils. The data also suggest that, during these reactions, the influence of a fraction of flavonoids and their polyphenolic derivatives on cellular functions may change. On the whole, the results of the study provide a better understanding of the effects of polyphenols on human health. In addition, these results reveal the structure-activity relationship of these polyphenols and may be useful in a search for new therapeutic agents against diseases associated with oxidative stress.
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Affiliation(s)
- Victoria S. Shubina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Institutskaya 3, 142290 Pushchino, Russia;
| | | | - Yuri V. Shatalin
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Institutskaya 3, 142290 Pushchino, Russia;
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Lv M, Su C, Huang F, Wang H, Wang Z, Zhang B, Du W. Association of Vegetable Consumption with Stroke in China: A Longitudinal Study. Nutrients 2023; 15:nu15071583. [PMID: 37049422 PMCID: PMC10096659 DOI: 10.3390/nu15071583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023] Open
Abstract
Research on the relationship between vegetable consumption and stroke among the Chinese population is still rare. This study aimed to explore the association between vegetable consumption and stroke. Using data from the China Health and Nutrition Survey (1991-2018), we included 15,145 participants over 40 years old without stroke as the baseline. Participants were categorized into five groups according to vegetable consumption. The adjusted HRs of stroke associated with vegetable consumption were calculated using the COX proportional hazards model. During the follow-up, 504 stroke cases were detected (303 men and 201 women). For the females, compared with the Q1 group of vegetable consumption, the multivariable-adjusted HRs for stroke were 0.60 (95%CI 0.36, 1.00) in the group of Q4. No significant associations between vegetable consumption and stroke were found among males. Furthermore, compared with the Q1 group of dark vegetable consumption, for the whole subjects, the multivariable-adjusted HRs for stroke were 0.68 (95%CI 0.50, 0.92) in the group of Q4. For the females, compared with the Q1 group of dark vegetable consumption, the multivariable-adjusted HRs for stroke were 0.49 (95%CI 0.30, 0.80) in the group of Q4. In conclusion, this study suggested that vegetable consumption decreases the risk of stroke among Chinese females. In addition, the intake of dark vegetables was inversely associated with stroke.
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Affiliation(s)
- Meiru Lv
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition of Health Commission of China, Beijing 100050, China
| | - Feifei Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Key Laboratory of Trace Element Nutrition of Health Commission of China, Beijing 100050, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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6
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Zhou F, Gu K, Zhou Y. Flavonoid intake is associated with lower all-cause and disease-specific mortality: The National Health and Nutrition Examination Survey 2007-2010 and 2017-2018. Front Nutr 2023; 10:1046998. [PMID: 36866051 PMCID: PMC9971007 DOI: 10.3389/fnut.2023.1046998] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Adequate intake of flavonoids may influence mortality, particularly of heart and cerebrovascular diseases. However, the importance of each flavonoid and its subclasses in preventing all-cause and disease-specific mortalities remain unclear. In addition, it is unknown which population groups would benefit from high flavonoid intake. Therefore, personalized mortality risk based on flavonoid intake needs to be estimated. The association between flavonoid intake and mortality among 14,029 participants in the National Health and Nutrition Examination Survey was examined using Cox proportional hazards analysis. A prognostic risk score and nomogram linking flavonoid intake and mortality were constructed. During a median follow-up of 117 months (9.75 years), 1,603 incident deaths were confirmed. Total flavonol intake was associated with a significantly reduced all-cause mortality [multivariable adjusted hazard ratio [HR] (95% confidence interval [CI]), 0.87 (0.81, 0.94), p for trend <0.001], especially in participants aged 50 years and older and former smokers. Similarly, total anthocyanidin intake was inversely associated with all-cause mortality [0.91 (0.84, 0.99), p for trend = 0.03], which was most significant in non-alcoholics. The intake of isoflavones was negatively associated with all-cause mortality [0.81 (0.70, 0.94), p = 0.01]. Moreover, a risk score was constructed based on survival-related flavonoid intake. The constructed nomogram accurately predicted the all-cause mortality of individuals based on flavonoid intake. Taken together, our results can be used to improve personalized nutrition.
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Affiliation(s)
- Fengying Zhou
- Department of Breast Diseases, Wuxi Meternal and Child Health Hospital, Women’s Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Ke Gu
- Department of Radiotherapy and Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China,Ke Gu, ✉
| | - Yanjun Zhou
- Department of Radiotherapy and Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China,*Correspondence: Yanjun Zhou, ✉
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7
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A Narrative Review of the Effects of Citrus Peels and Extracts on Human Brain Health and Metabolism. Nutrients 2022; 14:nu14091847. [PMID: 35565814 PMCID: PMC9103913 DOI: 10.3390/nu14091847] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
As life expectancy increases, age-associated diseases such as Alzheimer's disease (AD) become a major health problem. The onset of AD involves neurological dysfunction due to amyloid-β accumulation, tau hyperphosphorylation, oxidative stress, and neuroinflammation in the brain. In addition, lifestyle-related diseases-such as dyslipidemia, diabetes, obesity, and vascular dysfunction-increase the risk of developing dementia. The world population ages, prompting the development of new strategies to maintain brain health and prevent the onset of dementia in older and preclinical patients. Citrus fruits are abundant polymethoxylated flavone and flavanone sources. Preclinical studies reported that these compounds have neuroprotective effects in models of dementia such as AD. Interestingly, clinical and epidemiological studies appear to support preclinical evidence and show improved cognitive function and reduced associated disease risk in healthy individuals and/or patients. This review summarizes the recent evidence of the beneficial effects of citrus peels and extracts on human cognition and related functions.
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8
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Li XQ, Wang C, Yang T, Fan ZK, Guo XF. A meta-analysis of prospective cohort studies of flavonoid subclasses and stroke risk. Phytother Res 2022; 36:1103-1114. [PMID: 35023220 DOI: 10.1002/ptr.7376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/02/2021] [Accepted: 12/27/2021] [Indexed: 01/19/2023]
Abstract
Epidemiological studies indicate that higher intakes of flavonoids are associated with reduced stroke risk, however, which subtypes play significant roles to protect against stroke remain unclear. A systematic literature search in PubMed and Web of Science databases was performed up to Oct. 2021. Flavonoids or their subtypes (flavanol, flavanone, flavone, flavan-3-ol, isoflavone, or anthocyanin) were paired with stoke as the search term. Multivariate-adjusted relative risks (RRs) with 95% confidence intervals (CIs) for the highest versus the lowest category were pooled by using a random-effects model. Dose-response analysis was implemented by using a restricted cubic spline regression model. Ten independent prospective cohort studies with 387,076 participants and 9,564 events were included. Higher intakes of flavanones were inversely associated with stroke risk (RR = 0.85; 95%CI: 0.78, 0.93). Dose-response analysis showed that 50 mg/day increment of flavanones was associated with 11% reduction in stroke risk (RR = 0.89; 95%CI: 0.84, 0.94). Flavan-3-ols was marginally inversely associated with stroke risk (RR = 0.92; 95%CI: 0.82, 1.02). Dose-response analysis showed that 200 mg/day increment of flavan-3-ols was associated with 14% reduction in stroke risk (RR = 0.86; 95%CI: 0.75, 0.98). The non-significant association was observed with respect to other flavonoid subclasses. This study demonstrated higher intakes of flavanones and flavan-3-ols were associated with a lower risk of stroke. Dietary intakes of lemon and citrus rich in flavanones and flavan-3-ols might have beneficial functions for the protection against stroke. The findings of these associations of the present study need to be confirmed in other regions and ethnic origins.
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Affiliation(s)
- Xue-Qi Li
- Institute of Nutrition & Health, Qingdao University, Qingdao, China.,School of Public Health, Qingdao University, Qingdao, China
| | - Chong Wang
- Institute of Nutrition & Health, Qingdao University, Qingdao, China.,School of Public Health, Qingdao University, Qingdao, China
| | - Ting Yang
- Institute of Nutrition & Health, Qingdao University, Qingdao, China.,School of Public Health, Qingdao University, Qingdao, China
| | - Ze-Kai Fan
- Institute of Nutrition & Health, Qingdao University, Qingdao, China.,School of Public Health, Qingdao University, Qingdao, China
| | - Xiao-Fei Guo
- Institute of Nutrition & Health, Qingdao University, Qingdao, China.,School of Public Health, Qingdao University, Qingdao, China
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9
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Sebastian RS, Fanelli Kuczmarski M, Wilkinson Enns C, Goldman JD, Murayi T, Moshfegh AJ, Zonderman AB, Evans MK. Application of the Database of Flavonoid Values for USDA Food Codes 2007-2010 in Assessing Intake Differences Between the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) Study and What We Eat in America (WWEIA), NHANES. J Food Compost Anal 2021; 104:104124. [PMID: 34898846 PMCID: PMC8664081 DOI: 10.1016/j.jfca.2021.104124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Flavonoids are polyphenolic plant compounds whose biological activities may promote human health. It is worthwhile to examine whether flavonoid intake varies between populations with differing prevalence of diet-related diseases. This study compared flavonoid intakes in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study with nationally representative estimates from What We Eat in America (WWEIA), NHANES stratified by sex, age (30-49, 50-64 years), and poverty status (income <125%, >125% of the 2004 HHS Poverty Guidelines). Flavonoid intakes from both surveys were estimated using the Database of Flavonoid Values for USDA Food Codes 2007-2010. Across all subpopulations analyzed, intake of anthocyanidins was lower in HANDLS (p<0.01). Intakes of total flavonoids and all or most flavonoid classes were lower in HANDLS for men overall and in both age groups and for both men and women with poverty status <125%. These findings of lower flavonoid intakes in HANDLS, particularly among men and those with the lowest incomes, suggest that flavonoid intake may be a factor in the high prevalence of diet-related disease in populations represented by HANDLS. This research illustrates how any survey using USDA's food codes can utilize the Flavonoid Database in comparing flavonoid intakes.
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Affiliation(s)
- Rhonda S. Sebastian
- US Department of Agriculture, Agricultural Research Service, Food Surveys Research Group, BARC-West, 10300 Baltimore Ave, Bldg 005, Room 102, Beltsville, MD 20705-2350, USA
| | - Marie Fanelli Kuczmarski
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Health Disparities Research Section, NIH Biomedical Research Center 251 Bayview, Boulevard Baltimore, MD 21224, USA
| | - Cecilia Wilkinson Enns
- US Department of Agriculture, Agricultural Research Service, Food Surveys Research Group, BARC-West, 10300 Baltimore Ave, Bldg 005, Room 102, Beltsville, MD 20705-2350, USA
| | - Joseph D. Goldman
- US Department of Agriculture, Agricultural Research Service, Food Surveys Research Group, BARC-West, 10300 Baltimore Ave, Bldg 005, Room 102, Beltsville, MD 20705-2350, USA
| | - Theophile Murayi
- US Department of Agriculture, Agricultural Research Service, Food Surveys Research Group, BARC-West, 10300 Baltimore Ave, Bldg 005, Room 102, Beltsville, MD 20705-2350, USA
| | - Alanna J. Moshfegh
- US Department of Agriculture, Agricultural Research Service, Food Surveys Research Group, BARC-West, 10300 Baltimore Ave, Bldg 005, Room 102, Beltsville, MD 20705-2350, USA
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Health Disparities Research Section, NIH Biomedical Research Center 251 Bayview, Boulevard Baltimore, MD 21224, USA
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Health Disparities Research Section, NIH Biomedical Research Center 251 Bayview, Boulevard Baltimore, MD 21224, USA
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Shubina VS, Kozina VI, Shatalin YV. Comparison of Antioxidant Properties of a Conjugate of Taxifolin with Glyoxylic Acid and Selected Flavonoids. Antioxidants (Basel) 2021; 10:antiox10081262. [PMID: 34439510 PMCID: PMC8389318 DOI: 10.3390/antiox10081262] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 01/05/2023] Open
Abstract
It is known that flavonoids can react with toxic carbonyl compounds in the process of the storage, aging, and digestion of flavonoid-rich foods and beverages. However, the effect of these reactions on the antioxidant properties of the polyphenolic fraction and the properties of the resulting products remain poorly studied. The aim of the present work was to study the antioxidant activity of quercetin, taxifolin, catechin, eriodictyol, hesperetin, naringenin and a product of the condensation of taxifolin with glyoxylic acid, as well as to reveal the structure–activity relationship of these polyphenols. It was found that flavonoids containing the catechol moiety exhibited higher antioxidant activity than hesperetin and naringenin. The product showed the highest hydrogen peroxide scavenging activity, a lower metal-reducing and a higher iron-binding ability than catechol-containing flavonoids, and a lipid peroxidation inhibitory activity comparable with that of taxifolin. Thus, the condensation of flavonoids with toxic carbonyl compounds might lead to the formation of products exhibiting high antioxidant activity. Meanwhile, the conditions under which parent flavonoids and their products exhibit the maximal antioxidant activity may differ. The data suggest that the antioxidant profile of the polyphenolic fraction and bioavailability of polyphenols, carbonyl compounds, and metal ions may change when these reactions occur.
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11
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Parmenter BH, Dalgaard F, Murray K, Cassidy A, Bondonno CP, Lewis JR, Croft KD, Kyrø C, Gislason G, Scalbert A, Tjønneland A, Hodgson JM, Bondonno NP. Habitual flavonoid intake and ischemic stroke incidence in the Danish Diet, Cancer, and Health Cohort. Am J Clin Nutr 2021; 114:348-357. [PMID: 33963737 PMCID: PMC8246625 DOI: 10.1093/ajcn/nqab138] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Flavonoid-rich foods have antiinflammatory, antiatherogenic, and antithrombotic properties that may contribute to a lower risk of ischemic stroke. OBJECTIVES We aimed to investigate the relationship between habitual flavonoid consumption and incidence of ischemic stroke in participants from the Danish Diet, Cancer and Health Study. DESIGN In this prospective cohort study, 55,169 Danish residents without a prior ischemic stroke [median (IQR) age at enrolment of 56 y (52-60)], were followed for 21 y (20-22). We used Phenol-Explorer to estimate flavonoid intake from food frequency questionnaires obtained at study entry. Incident cases of ischemic stroke were identified from Danish nationwide registries and restricted cubic splines in Cox proportional hazards models were used to investigate relationships with flavonoid intake. RESULTS During follow-up, 4237 individuals experienced an ischemic stroke. Compared with participants in Q1 and after multivariable adjustment for demographics and lifestyle factors, those in Q5-for intake of total flavonoids, flavonols, and flavanol oligo + polymers-had a 12% [HR (95% CI): 0.88 (0.81, 0.96)], 10% [0.90 (0.82, 0.98)], and 18% [0.82 (0.75, 0.89)] lower risk of ischemic stroke incidence, respectively. Multivariable (demographic and lifestyle) adjusted associations for anthocyanins and flavones with risk of ischemic stroke were not linear, with moderate but not higher intakes associated with lower risk [anthocyanins Q3 vs. Q1 HR (95% CI): 0.85 (0.79, 0.93); flavones: 0.90 (0.84, 0.97)]. Following additional adjustment for dietary confounders, similar point estimates were observed; however, significance was only retained for anthocyanins and flavanol oligo + polymers [anthocyanins Q3 vs. Q1 HR (95% CI): 0.86 (0.79, 0.94); flavanol oligo + polymers Q5 vs. Q1 0.86 (0.78, 0.94)]. CONCLUSIONS These findings suggest that moderate habitual consumption of healthy flavonoid-rich foods is associated with a lower risk of ischemic stroke and further investigation is therefore warranted.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Australia
| | - Aedin Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
- Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, Australia
| | - Kevin D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
| | - Cecilie Kyrø
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Gunnar Gislason
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
- The National Institute of Public Health, University of Southern Denmark, Odense, Denmark
- The Danish Heart Foundation, Copenhagen, Denmark
| | | | - Anne Tjønneland
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Nicola P Bondonno
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Micek A, Godos J, Del Rio D, Galvano F, Grosso G. Dietary Flavonoids and Cardiovascular Disease: A Comprehensive Dose-Response Meta-Analysis. Mol Nutr Food Res 2021; 65:e2001019. [PMID: 33559970 DOI: 10.1002/mnfr.202001019] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/18/2021] [Indexed: 12/13/2022]
Abstract
SCOPE Dietary flavonoids have shown potential in the prevention of noncommunicable diseases. The aim of the present study is to conduct a dose-response meta-analysis on the association between dietary intake of total, subclasses and individual flavonoids and risk of cardiovascular disease (CVD). METHODS AND RESULTS Electronic databases are searched. A total of 39 prospective cohort studies are included, comprising 1 501 645 individuals and a total of 33 637 cases of CVD, 23 664 of coronary heart disease (CHD), and 11 860 of stroke. Increasing dietary intake of total flavonoids is linearly associated with a lower risk of CVD. Among the main classes of flavonoids, increasing intake of anthocyanins and flavan-3-ols is inversely associated with risk of CVD, while flavonols and flavones with CHD. Only increasing flavanones showed a linear inverse association with stroke risk. Catechins showed a favorable effect toward all cardiovascular outcomes. Among individual compounds, intake of quercetin and kaempferol is linearly associated with lower risk of CHD and CVD, respectively. However, higher intake of all the aforementioned compounds is associated, with a various extent, with a lower risk of CVD when considering comparison of extreme categories of consumption. CONCLUSION The results of this study provide evidence of potential cardiovascular benefits of a flavonoid-rich diet.
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Affiliation(s)
- Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Daniele Del Rio
- School of Advanced Studies on Food and Nutrition, University of Parma, Parma, Italy.,Department of Veterinary Science, University of Parma, Parma, Italy
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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13
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Pontifex MG, Malik MMAH, Connell E, Müller M, Vauzour D. Citrus Polyphenols in Brain Health and Disease: Current Perspectives. Front Neurosci 2021; 15:640648. [PMID: 33679318 PMCID: PMC7933480 DOI: 10.3389/fnins.2021.640648] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/25/2021] [Indexed: 12/17/2022] Open
Abstract
In addition to essential micronutrients such as vitamin C, citrus fruits represent a considerably rich source of non-essential bioactive compounds, in particular flavanones which form a sub-set of the flavonoid group. Preclinical studies have demonstrated the neuroprotective potential of citrus flavonoids and have highlighted both the well-established (anti-inflammatory and anti-oxidative properties), and newly emerging (influence upon blood-brain barrier function/integrity) mechanistic actions by which these neurological effects are mediated. Encouragingly, results from human studies, although limited in number, appear to support this preclinical basis, with improvements in cognitive performance and disease risk observed across healthy and disease states. Therefore, citrus fruits - both as whole fruit and 100% juices - should be encouraged within the diet for their potential neurological benefit. In addition, there should be further exploration of citrus polyphenols to establish therapeutic efficacy, particularly in the context of well-designed human interventions.
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Affiliation(s)
- Matthew G Pontifex
- Norwich Medical School, Biomedical Research Centre, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Mohammad M A H Malik
- Norwich Medical School, Biomedical Research Centre, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Emily Connell
- Norwich Medical School, Biomedical Research Centre, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Michael Müller
- Norwich Medical School, Biomedical Research Centre, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - David Vauzour
- Norwich Medical School, Biomedical Research Centre, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
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14
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You T, Li Y, Wu X, Wu S, Zhang Y, Zhou X. Combined lifestyle factors are associated with the risk of ischaemic stroke in a Chinese population. Postgrad Med J 2021; 98:e8. [PMID: 33541926 DOI: 10.1136/postgradmedj-2020-139548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Lifestyle plays an important role in the development of ischaemic stroke (IS). The objective of this study was to evaluate the association between combined lifestyle factors and the risk of IS in an eastern Chinese population. METHODS We collected lifestyle information from 191 patients with IS admitted to the second affiliated hospital of Soochow University and 575 control subjects from community clinics using a structured questionnaire. After division into training and test datasets, regularised stepwise logistic regression, least absolute shrinkage and selection operator regression and genetic algorithm models were used to identify lifestyle factors associated with IS. The improved discriminative ability by adding the lifestyle factors was determined by c-index and reclassification analysis. The final model was validated in the test dataset. RESULTS After controlling for conventional cardiovascular disease (CVD) risk factors, preferences for fruits (OR (95% CI): 0.29 (0.18-0.46), p<0.001) and soy products (0.47 (0.29-0.75), p=0.002) were negatively associated with IS, while lower life satisfaction (mildly satisfied: 2.15 (1.27-3.63), p=0.004; not satisfied: 6.39 (1.76-25.44), p=0.006) was positively associated with IS. Adding these factors to a basic CVD risk model improved the c-index (0.825 vs 0.753, p<0.001) and reclassification for IS (net reclassification index (95% CI): 18.49% (7.90%-29.08%), integrated discrimination index (95% CI): 0.11% (0.08%-0.14%), p<0.001). The model with lifestyle factors achieved a c-index of 0.813 and good calibration in the test dataset. CONCLUSIONS Our results showed that combined lifestyle factors including dietary pattern and life satisfaction are independently associated with the risk of IS.
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Affiliation(s)
- Tao You
- Department of Cardiology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yi Li
- Department of Cardiology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiaoguang Wu
- Department of Cardiology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Siyi Wu
- Department of Cardiology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yanlin Zhang
- Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiang Zhou
- Department of Cardiology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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15
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Zurbau A, Au‐Yeung F, Blanco Mejia S, Khan TA, Vuksan V, Jovanovski E, Leiter LA, Kendall CWC, Jenkins DJA, Sievenpiper JL. Relation of Different Fruit and Vegetable Sources With Incident Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. J Am Heart Assoc 2020; 9:e017728. [PMID: 33000670 PMCID: PMC7792377 DOI: 10.1161/jaha.120.017728] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
Background Public health policies reflect concerns that certain fruit sources may not have the intended benefits and that vegetables should be preferred to fruit. We assessed the relation of fruit and vegetable sources with cardiovascular outcomes using a systematic review and meta-analysis of prospective cohort studies. Methods and Results MEDLINE, EMBASE, and Cochrane were searched through June 3, 2019. Two independent reviewers extracted data and assessed study quality (Newcastle-Ottawa Scale). Data were pooled (fixed effects), and heterogeneity (Cochrane-Q and I2) and certainty of the evidence (Grading of Recommendations Assessment, Development, and Evaluation) were assessed. Eighty-one cohorts involving 4 031 896 individuals and 125 112 cardiovascular events were included. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (risk ratio, 0.93 [95% CI, 0.89-0.96]; 0.91 [0.88-0.95]; and 0.94 [0.90-0.97], respectively), coronary heart disease (0.88 [0.83-0.92]; 0.88 [0.84-0.92]; and 0.92 [0.87-0.96], respectively), and stroke (0.82 [0.77-0.88], 0.82 [0.79-0.85]; and 0.88 [0.83-0.93], respectively) incidence. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (0.89 [0.85-0.93]; 0.88 [0.86-0.91]; and 0.87 [0.85-0.90], respectively), coronary heart disease (0.81 [0.72-0.92]; 0.86 [0.82-0.90]; and 0.86 [0.83-0.89], respectively), and stroke (0.73 [0.65-0.81]; 0.87 [0.84-0.91]; and 0.94 [0.90-0.99], respectively) mortality. There were greater benefits for citrus, 100% fruit juice, and pommes among fruit sources and allium, carrots, cruciferous, and green leafy among vegetable sources. No sources showed an adverse association. The certainty of the evidence was "very low" to "moderate," with the highest for total fruit and/or vegetables, pommes fruit, and green leafy vegetables. Conclusions Fruits and vegetables are associated with cardiovascular benefit, with some sources associated with greater benefit and none showing an adverse association. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03394339.
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Affiliation(s)
- Andreea Zurbau
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Fei Au‐Yeung
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Sonia Blanco Mejia
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Tauseef A. Khan
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Vladimir Vuksan
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
| | - Elena Jovanovski
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
| | - Lawrence A. Leiter
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
- Department of Medicine, Faculty of MedicineUniversity of TorontoOntarioCanada
| | - Cyril W. C. Kendall
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- College of Pharmacy and NutritionUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - David J. A. Jenkins
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
| | - John L. Sievenpiper
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
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Kao MH, Wu JS, Cheung WM, Chen JJ, Sun GY, Ong WY, Herr DR, Lin TN. Clinacanthus nutans Mitigates Neuronal Death and Reduces Ischemic Brain Injury: Role of NF-κB-driven IL-1β Transcription. Neuromolecular Med 2020; 23:199-210. [PMID: 33025396 DOI: 10.1007/s12017-020-08618-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/26/2020] [Indexed: 12/15/2022]
Abstract
Neuroinflammation has been shown to exacerbate ischemic brain injury, and is considered as a prime target for the development of stroke therapies. Clinacanthus nutans Lindau (C. nutans) is widely used in traditional medicine for treating insect bites, viral infection and cancer, due largely to its anti-oxidative and anti-inflammatory properties. Recently, we reported that an ethanol extract from the leaf of C. nutans could protect the brain against ischemia-triggered neuronal death and infarction. In order to further understand the molecular mechanism(s) for its beneficial effects, two experimental paradigms, namely, in vitro primary cortical neurons subjected to oxygen-glucose deprivation (OGD) and in vivo rat middle cerebral artery (MCA) occlusion, were used to dissect the anti-inflammatory effects of C. nutans extract. Using promoter assays, immunofluorescence staining, and loss-of-function (siRNA) approaches, we demonstrated that transient OGD led to marked induction of IL-1β, IL-6 and TNFα, while pretreatment with C. nutans suppressed production of inflammatory cytokines in primary neurons. C. nutans inhibited IL-1β transcription via preventing NF-κB/p65 nuclear translocation, and siRNA knockdown of either p65 or IL-1β mitigated OGD-mediated neuronal death. Correspondingly, post-ischemic treatment of C. nutans attenuated IκBα degradation and decreased IL-1β, IL-6 and TNFα production in the ischemic brain. Furthermore, IL-1β siRNA post-ischemic treatment reduced cerebral infarct, thus mimicking the beneficial effects of C. nutans. In summary, our findings demonstrated the ability for C. nutans to suppress NF-κB nuclear translocation and inhibit IL-1β transcription in ischemic models. Results further suggest the possibility for using C. nutans to prevent and treat stroke patients.
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Affiliation(s)
- Mei-Han Kao
- Taiwan International Graduate Program in Molecular Medicine, National Yang-Ming University and Academia Sinica, Taipei, Taiwan
| | - Jui-Sheng Wu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, ROC
| | - Wai-Mui Cheung
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, ROC
| | - Jin-Jer Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, ROC
| | - Grace Y Sun
- Department of Biochemistry, University of Missouri, Columbia, USA
| | - Wei-Yi Ong
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119260, Singapore.,Neurobiology Programme, Life Sciences Institute, National University of Singapore, Singapore, 119260, Singapore
| | - Deron R Herr
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119260, Singapore
| | - Teng-Nan Lin
- Taiwan International Graduate Program in Molecular Medicine, National Yang-Ming University and Academia Sinica, Taipei, Taiwan. .,Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, ROC.
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17
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Parmenter BH, Croft KD, Hodgson JM, Dalgaard F, Bondonno CP, Lewis JR, Cassidy A, Scalbert A, Bondonno NP. An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk. Food Funct 2020; 11:6777-6806. [PMID: 32725042 DOI: 10.1039/d0fo01118e] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is an accumulating body of literature reporting on dietary flavonoid intake and the risk of cardiovascular disease (CVD) in prospective cohort studies. This makes apparent the need for an overview and update on the current state of the science. To date, at least 27 prospective cohorts (in 44 publications) have evaluated the association between estimated habitual flavonoid intake and CVD risk. At this time, the totality of evidence suggests long-term consumption of flavonoid-rich foods may be associated with a lower risk of fatal and non-fatal ischemic heart disease (IHD), cerebrovascular disease, and total CVD; disease outcomes which are principally, though not exclusively, composed of cases of atherosclerotic CVD (ASCVD). To date, few studies have investigated outcome specific ASCVD, such as peripheral artery disease (PAD) or ischemic stroke. Of the flavonoid subclasses investigated, evidence more often implicates diets rich in anthocyanins, flavan-3-ols, and flavonols in lowering the risk of CVD. Although inferences are restricted by confounding and other inherent limitations of observational studies, causality appears possible based on biological plausibility, temporality, and the relative consistency of the reported associations. However, whether the associations observed represent a benefit of the isolated bioactives per se, or are a signal of the bioactives acting in concert with the co-occurring nutrient matrix within flavonoid-bearing foods, are issues of consideration. Thus, the simple interpretation, and the one most relevant for dietary advice, is that consumption of flavonoid-rich foods or diets higher in flavonoids, appear nutritionally beneficial in the prevention of CVD.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Kevin D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia and Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, Australia
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Augustin Scalbert
- Biomarkers Group, International Agency for Research on Cancer, Lyon, France
| | - Nicola P Bondonno
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia. and School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
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Abstract
Previous studies reported an inverse association between healthy dietary patterns (such as Mediterranean diet) and the incidence of cardiovascular events. As the mechanism accounting for cardiovascular disease is prevalently due to the atherothrombosis, where a pivotal role is played by platelet activation, it would be arguable that diets with protective effects against cardiovascular disease exert an anti-atherothrombotic effect via inhibition of platelet activation. There are several and sparse typologies of studies, which investigated if single nutrients by diets recognized as having cardiovascular protection may exert an antithrombotic effect. The most investigated nutrients are key components of the Mediterranean diets such as fruits and vegetables, fish, olive oil, and wine; other diets with protective effects include nuts and cocoa. Here we summarize experimental and human interventional studies which investigated the antithrombotic effects of such nutrients in experimental models of thrombosis or analyzed biomarkers of clotting, platelet, and fibrinolysis activation in human; furthermore in vitro studies explored the underlying mechanism at level of several cell lines such as platelets or endothelial cells. In this context, we analyzed if nutrients affect simultaneously or separately clotting, platelet, and fibrinolysis pathways giving special attention to the relationship between oxidative stress and thrombosis as most nutrients are believed to possess antioxidant properties.
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Affiliation(s)
- Francesco Violi
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.).,Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.)
| | - Daniele Pastori
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.)
| | - Pasquale Pignatelli
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.).,Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.)
| | - Roberto Carnevale
- Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.).,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy (R.C.)
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19
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Raman G, Avendano EE, Chen S, Wang J, Matson J, Gayer B, Novotny JA, Cassidy A. Dietary intakes of flavan-3-ols and cardiometabolic health: systematic review and meta-analysis of randomized trials and prospective cohort studies. Am J Clin Nutr 2019; 110:1067-1078. [PMID: 31504087 PMCID: PMC6821550 DOI: 10.1093/ajcn/nqz178] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 07/10/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although available data suggest that some dietary flavan-3-ol sources reduce cardiometabolic risk, to our knowledge no review has systematically synthesized their specific contribution. OBJECTIVE We aimed to examine, for the first time, if there is consistent evidence that higher flavan-3-ol intake, irrespective of dietary source, reduces cardiometabolic risk. METHODS MEDLINE, Cochrane Central, and Commonwealth Agricultural Bureau abstracts were searched for prospective cohorts and randomized controlled trials (RCTs) published from 1946 to March 2019 on flavan-3-ol intake and cardiovascular disease (CVD) risk. Random-effects models meta-analysis was used. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach assessed the strength of evidence. RESULTS Of 15 prospective cohorts (23 publications), 4 found highest compared with lowest habitual intakes of flavan-3-ols were associated with a 13% reduction in risk of CVD mortality and 2 found a 19% reduction in risk of chronic heart disease (CHD) incidence. Highest compared with lowest habitual intakes of monomers were associated with a reduction in risk of type 2 diabetes mellitus (T2DM) (n = 5) and stroke (n = 4) (10% and 18%, respectively). No association was found for hypertension. Of 156 RCTs, flavan-3-ol intervention resulted in significant improvements in acute/chronic flow-mediated dilation (FMD), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), LDL and HDL cholesterol, triglycerides (TGs), hemoglobin A1c (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR). All analyses, except HbA1c, were associated with moderate/high heterogeneity. When analyses were limited to good methodological quality studies, improvements in TC, HDL cholesterol, SBP, DBP, HOMA-IR, and acute/chronic FMD remained significant. In GRADE evaluations, there was moderate evidence in cohort studies that flavan-3-ol and monomer intakes were associated with reduced risk of CVD mortality, CHD, stroke, and T2DM, whereas RCTs reported improved TC, HDL cholesterol, SBP, and HOMA-IR. CONCLUSIONS Available evidence supports a beneficial effect of flavan-3-ol intake on cardiometabolic outcomes, but there was considerable heterogeneity in the meta-analysis. Future research should focus on an integrated intake/biomarker approach in cohorts and high-quality dose-response RCTs. This review was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42018035782.
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Affiliation(s)
- Gowri Raman
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Address correspondence to GR (e-mail: )
| | - Esther E Avendano
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Siyu Chen
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Jiaqi Wang
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Julia Matson
- Department of Biology, Brandeis University, Waltham, MA, USA
| | - Bridget Gayer
- Tufts Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Janet A Novotny
- Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD, USA
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
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20
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Ham D, Jun S, Kang M, Paik HY, Joung H, Shin S. Consumption of Korean Foods with High Flavonoid Contents Reduces the Likelihood of Having Elevated C-Reactive Protein Levels: Data from the 2015-2017 Korea National Health and Nutrition Examination Survey. Nutrients 2019; 11:nu11102370. [PMID: 31590321 PMCID: PMC6836232 DOI: 10.3390/nu11102370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/26/2019] [Accepted: 10/01/2019] [Indexed: 01/07/2023] Open
Abstract
This study was conducted to investigate associations between C-reactive protein (CRP) levels and Korean food (KF) consumption and flavonoid intake from the 2015-2017 Korea National Health and Nutrition Examination Survey. A total of 6025 men and 8184 women (≥19 years) who completed a 24-h dietary recall and health examination were analyzed. The individual KF consumption rate was defined as the proportion of KF of total food consumed and categorized into tertiles. Odds ratios (ORs) for elevated CRP levels (>3.0 mg/L) according to KF consumption rate and flavonoid intake/dietary total antioxidant capacity (TAC) (<median; ≥median) were obtained by multiple logistic regression. KF consumption was inversely associated with CRP levels in women (p = 0.0236) and positively associated with flavonoid intake/dietary TAC in both sexes (p < 0.0001). Compared to women who consumed less than the median amount of flavonoid or TAC with KF consumption rates in the lowest tertile, those who consumed more flavonoid (OR = 0.59, 95% CI 0.42-0.83) or TAC (OR = 0.58, 95% CI 0.41-0.82) in the highest tertile showed significantly lower ORs for elevated CRP levels. Thus, consuming KFs rich in flavonoid is effective for regulating CRP levels.
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Affiliation(s)
- Dongwoo Ham
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea.
| | - Shinyoung Jun
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
| | - Minji Kang
- Center for Gendered Innovations in Science and Technology Research (GISTeR), Korea Federation of Women's Science & Technology Associations, Seoul 06130, Korea.
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
| | - Hee-Young Paik
- Center for Gendered Innovations in Science and Technology Research (GISTeR), Korea Federation of Women's Science & Technology Associations, Seoul 06130, Korea.
| | - Hyojee Joung
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea.
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea.
| | - Sangah Shin
- Department of Food and Nutrition, College of Biotechnology and Natural Resources, Chung-Ang University, Gyeonggi-do 17546, Korea.
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Dahiya R, Mohammad T, Gupta P, Haque A, Alajmi MF, Hussain A, Hassan MI. Molecular interaction studies on ellagic acid for its anticancer potential targeting pyruvate dehydrogenase kinase 3. RSC Adv 2019; 9:23302-23315. [PMID: 35514501 PMCID: PMC9067284 DOI: 10.1039/c9ra02864a] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/15/2019] [Indexed: 11/21/2022] Open
Abstract
Pyruvate dehydrogenase kinase 3 (PDK3) plays a central role in the cancer metabolic switch through the reversible phosphorylation of pyruvate dehydrogenase complex thereby blocking the entry of pyruvate for its catabolism into the TCA cycle, and thus it is considered as an important drug target for various types of cancers. We have successfully expressed full length human PDK3 and investigated its interaction mechanism with dietary polyphenols in the search for potential inhibitors. Molecular docking analysis revealed that the selected compounds preferentially bind to the ATP-binding pocket of PDK3 and interact with functionally important residues. In silico observations were further complemented by experimental measurements of the fluorescence quenching of PDK3 and confirmed with the isothermal titration calorimetry measurements. Ellagic acid (EA) significantly binds and inhibits the kinase activity of PDK3. In vitro cytotoxicity and the anti-proliferative properties of EA were evaluated by MTT assay. Conformational dynamics of the EA-PDK3 complex during molecular dynamics simulation revealed that a stable complex was maintained by a significant number of hydrogen bonds throughout the 100 ns trajectories. In conclusion, EA may be considered as a promising molecule for PDK3 inhibition and could be exploited as a lead molecule against PDK3 associated diseases.
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Affiliation(s)
- Rashmi Dahiya
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia Jamia Nagar New Delhi 110025 India
| | - Taj Mohammad
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia Jamia Nagar New Delhi 110025 India
| | - Preeti Gupta
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia Jamia Nagar New Delhi 110025 India
| | - Anzarul Haque
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia Jamia Nagar New Delhi 110025 India
| | - Mohamed F Alajmi
- Department of Pharmacognosy College of Pharmacy, King Saud University Riyadh 11451 Kingdom of Saudi Arabia
| | - Afzal Hussain
- Department of Pharmacognosy College of Pharmacy, King Saud University Riyadh 11451 Kingdom of Saudi Arabia
| | - Md Imtaiyaz Hassan
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia Jamia Nagar New Delhi 110025 India
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Stevens Y, Rymenant EV, Grootaert C, Camp JV, Possemiers S, Masclee A, Jonkers D. The Intestinal Fate of Citrus Flavanones and Their Effects on Gastrointestinal Health. Nutrients 2019; 11:nu11071464. [PMID: 31252646 PMCID: PMC6683056 DOI: 10.3390/nu11071464] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 02/06/2023] Open
Abstract
Citrus flavanones, with hesperidin and naringin as the most abundant representatives, have various beneficial effects, including anti-oxidative and anti-inflammatory activities. Evidence also indicates that they may impact the intestinal microbiome and are metabolized by the microbiota as well, thereby affecting their bioavailability. In this review, we provide an overview on the current evidence on the intestinal fate of hesperidin and naringin, their interaction with the gut microbiota, and their effects on intestinal barrier function and intestinal inflammation. These topics will be discussed as they may contribute to gastrointestinal health in various diseases. Evidence shows that hesperidin and naringin are metabolized by intestinal bacteria, mainly in the (proximal) colon, resulting in the formation of their aglycones hesperetin and naringenin and various smaller phenolics. Studies have also shown that citrus flavanones and their metabolites are able to influence the microbiota composition and activity and exert beneficial effects on intestinal barrier function and gastrointestinal inflammation. Although the exact underlying mechanisms of action are not completely clear and more research in human subjects is needed, evidence so far suggests that citrus flavanones as well as their metabolites have the potential to contribute to improved gastrointestinal function and health.
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Affiliation(s)
- Yala Stevens
- Department of Internal Medicine, Division of Gastroenterology-Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
- BioActor BV, Gaetano Martinolaan 85, 6229 GS Maastricht, The Netherlands.
| | - Evelien Van Rymenant
- Department of Food Technology, Safety and Health, Research Group Food Chemistry and Human Nutrition, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - Charlotte Grootaert
- Department of Food Technology, Safety and Health, Research Group Food Chemistry and Human Nutrition, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - John Van Camp
- Department of Food Technology, Safety and Health, Research Group Food Chemistry and Human Nutrition, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | | | - Adrian Masclee
- Department of Internal Medicine, Division of Gastroenterology-Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Daisy Jonkers
- Department of Internal Medicine, Division of Gastroenterology-Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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23
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Del Bo' C, Bernardi S, Marino M, Porrini M, Tucci M, Guglielmetti S, Cherubini A, Carrieri B, Kirkup B, Kroon P, Zamora-Ros R, Liberona NH, Andres-Lacueva C, Riso P. Systematic Review on Polyphenol Intake and Health Outcomes: Is there Sufficient Evidence to Define a Health-Promoting Polyphenol-Rich Dietary Pattern? Nutrients 2019; 11:E1355. [PMID: 31208133 PMCID: PMC6627994 DOI: 10.3390/nu11061355] [Citation(s) in RCA: 229] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 12/21/2022] Open
Abstract
Growing evidence support association between polyphenol intake and reduced risk for chronic diseases, even if there is a broad debate about the effective amount of polyphenols able to exert such protective effect. The present systematic review provides an overview of the last 10-year literature on the evaluation of polyphenol intake and its association with specific disease markers and/or endpoints. An estimation of the mean total polyphenol intake has been performed despite the large heterogeneity of data reviewed. In addition, the contribution of dietary sources was considered, suggesting tea, coffee, red wine, fruit and vegetables as the main products providing polyphenols. Total flavonoids and specific subclasses, but not total polyphenols, have been apparently associated with a low risk of diabetes, cardiovascular events and all-cause mortality. However, large variability in terms of methods for the evaluation and quantification of polyphenol intake, markers and endpoints considered, makes it still difficult to establish an evidence-based reference intake for the whole class and subclass of compounds. Nevertheless, the critical mass of data available seem to strongly suggest the protective effect of a polyphenol-rich dietary pattern even if further well targeted and methodologically sound research should be encouraged in order to define specific recommendations.
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Affiliation(s)
- Cristian Del Bo'
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Stefano Bernardi
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Mirko Marino
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Massimiliano Tucci
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Simone Guglielmetti
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, 60127 Ancona, Italy.
| | - Barbara Carrieri
- Geriatria, Accettazione Geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, 60127 Ancona, Italy.
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 60131 Ancona, Italy.
| | - Benjamin Kirkup
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UG, UK.
| | - Paul Kroon
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UG, UK.
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain.
| | - Nicole Hidalgo Liberona
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain.
- CIBER Fragilidad y Envejecimiento Saludable (CIBERfes), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Cristina Andres-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain.
- CIBER Fragilidad y Envejecimiento Saludable (CIBERfes), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
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Maaliki D, Shaito AA, Pintus G, El-Yazbi A, Eid AH. Flavonoids in hypertension: a brief review of the underlying mechanisms. Curr Opin Pharmacol 2019; 45:57-65. [DOI: 10.1016/j.coph.2019.04.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/12/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022]
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Sánchez M, Romero M, Gómez-Guzmán M, Tamargo J, Pérez-Vizcaino F, Duarte J. Cardiovascular Effects of Flavonoids. Curr Med Chem 2019; 26:6991-7034. [DOI: 10.2174/0929867326666181220094721] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
:
Cardiovascular Disease (CVD) is the major cause of death worldwide, especially in Western
society. Flavonoids are a large group of polyphenolic compounds widely distributed in plants, present
in a considerable amount in fruit and vegetable. Several epidemiological studies found an inverse association
between flavonoids intake and mortality by CVD. The antioxidant effect of flavonoids was
considered the main mechanism of action of flavonoids and other polyphenols. In recent years, the role
of modulation of signaling pathways by direct interaction of flavonoids with multiple protein targets,
namely kinases, has been increasingly recognized and involved in their cardiovascular protective effect.
There are strong evidence, in in vitro and animal experimental models, that some flavonoids induce
vasodilator effects, improve endothelial dysfunction and insulin resistance, exert platelet antiaggregant
and atheroprotective effects, and reduce blood pressure. Despite interacting with multiple targets, flavonoids
are surprisingly safe. This article reviews the recent evidence about cardiovascular effects that
support a beneficial role of flavonoids on CVD and the potential molecular targets involved.
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Affiliation(s)
- Manuel Sánchez
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Miguel Romero
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Manuel Gómez-Guzmán
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Juan Tamargo
- Department of Pharmacology, School of Medicine, Complutense University of Madrid and Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Francisco Pérez-Vizcaino
- Department of Pharmacology, School of Medicine, Complutense University of Madrid and Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Juan Duarte
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
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26
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Dietary Flavonoid Intakes Are Associated with Race but Not Income in an Urban Population. Nutrients 2018; 10:nu10111749. [PMID: 30428592 PMCID: PMC6266237 DOI: 10.3390/nu10111749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 12/30/2022] Open
Abstract
Flavonoids are polyphenolic phytochemicals with health-promoting properties, yet knowledge about their intake in at-risk populations is limited. This study sought to estimate intakes of total flavonoids and six flavonoid classes in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study; determine if differences in intakes exist by race (African American (AA) and White (W)) and income (< or >125% Federal poverty guidelines); and compare intakes to those of a nationally representative population with similar demographic and socioeconomic characteristics. Data transformation normalized the flavonoid intake distributions prior to conducting statistical tests. With the exception of the flavanone class, flavonoid intakes of AAs were significantly lower than those of W (p < 0.01), regardless of other potential mediating factors including sex, age, and income. Total flavonoid intakes in HANDLS did not differ from intakes in the nationally representative study, but anthocyanidin and flavone intakes were lower, and race specific differences were found for several flavonoid classes. These findings imply that benefits attributable to flavonoid consumption may not be experienced equally by AAs and Whites, nor in vulnerable populations such as that represented by HANDLS relative to the U.S. population, and may play a role in observed health disparities.
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27
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Hou X, Qin X, Li Q. Structure‑activity associations in novel farrerol derivatives with vasorelaxant properties. Mol Med Rep 2018; 18:4709-4715. [DOI: 10.3892/mmr.2018.9439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 08/13/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- Xiaomin Hou
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Xiaojiang Qin
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Qingshan Li
- School of Pharmaceutical Science, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
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28
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Dietary Intake of Curcumin Improves eIF2 Signaling and Reduces Lipid Levels in the White Adipose Tissue of Obese Mice. Sci Rep 2018; 8:9081. [PMID: 29899429 PMCID: PMC5998036 DOI: 10.1038/s41598-018-27105-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/23/2018] [Indexed: 12/13/2022] Open
Abstract
White adipose tissue (eWAT) plays a crucial role in preventing metabolic syndrome. We aimed to investigate WAT distribution and gene expression and lipidomic profiles in epididymal WAT (eWAT) in diet-induced obese mice, reflecting a Western-style diet of humans to elucidate the bioactive properties of the dietary antioxidant curcumin in preventing lifestyle-related diseases. For 16 weeks, we fed C57BL/6J mice with a control diet, a high-fat, high-sucrose and high-cholesterol Western diet or Western diet supplemented with 0.1% (w/w) curcumin. Although the dietary intake of curcumin did not affect eWAT weight or plasma lipid levels, it reduced lipid peroxidation markers’ levels in eWAT. Curcumin accumulated in eWAT and changed gene expressions related to eukaryotic translation initiation factor 2 (eIF2) signalling. Curcumin suppressed eIF2α phosphorylation, which is induced by endoplasmic reticulum (ER) stress, macrophage accumulation and nuclear factor-κB (NF-κB) p65 and leptin expression, whereas it’s anti-inflammatory effect was inadequate to decrease TNF-α and IFN-γ levels. Lipidomic and gene expression analysis revealed that curcumin decreased some diacylglycerols (DAGs) and DAG-derived glycerophospholipids levels by suppressing the glycerol-3-phosphate acyltransferase 1 and adipose triglyceride lipase expression, which are associated with lipogenesis and lipolysis, respectively. Presumably, these intertwined effects contribute to metabolic syndrome prevention by dietary modification.
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29
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Asgary S, Rastqar A, Keshvari M. Functional Food and Cardiovascular Disease Prevention and Treatment: A Review. J Am Coll Nutr 2018. [PMID: 29528772 DOI: 10.1080/07315724.2017.1410867] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Lifestyle factors, including nutrition, play an important role in the etiology and treatment of CVD. Functional foods based on their basic nutritional functions can decrease the risk of many chronic diseases and have some physiological benefits. They contain physiologically active components either from plant or animal sources, marketed with the claim of their ability to reduce heart disease risk, focusing primarily on established risk factors, which are hyperlipidemia, diabetes, metabolic syndrome, obesity/overweight, elevated lipoprotein A level, small dense low-density lipoprotein cholesterol (LDL-C), and elevated inflammatory marker levels. Functional foods are suspected to exert their cardioprotective effects mainly through blood lipid profile level and improve hypertension control, endothelial function, platelet aggregation, and antioxidant actions. Clinical and epidemiological observations indicate that vegetable and fruit fiber, nuts and seeds, sea foods, coffee, tea, and dark chocolate have cardioprotective potential in humans, as well whole-grain products containing intact grain kernels rich in fiber and trace nutrients. They are nutritionally more important because they contain phytoprotective substances that might work synergistically to reduce cardiovascular risk. This review will focus on the reciprocal interaction between functional foods and the potential link to cardiovascular health and the possible mechanisms of action.
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Affiliation(s)
- Sedigheh Asgary
- a Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Ali Rastqar
- b Department of Psychiatry and Neuroscience , Université Laval, Québec , Québec , Canada.,c Research Center of University Affiliated Québec Mental Health Institute, Québec , Québec , Canada
| | - Mahtab Keshvari
- a Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences , Isfahan , Iran
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Abstract
A growing body of nutritional science highlights the complex mechanisms and pleiotropic pathways of cardiometabolic effects of different foods. Among these, some of the most exciting advances are occurring in the area of flavonoids, bioactive phytochemicals found in plant foods; and in the area of dairy, including milk, yogurt, and cheese. Many of the relevant ingredients and mechanistic pathways are now being clarified, shedding new light on both the ingredients and the pathways for how diet influences health and well-being. Flavonoids, for example, have effects on skeletal muscle, adipocytes, liver, and pancreas, and myocardial, renal, and immune cells, for instance, related to 5'-monophosphate-activated protein kinase phosphorylation, endothelial NO synthase activation, and suppression of NF-κB (nuclear factor-κB) and TLR4 (toll-like receptor 4). Effects of dairy are similarly complex and may be mediated by specific amino acids, medium-chain and odd-chain saturated fats, unsaturated fats, branched-chain fats, natural trans fats, probiotics, vitamin K1/K2, and calcium, as well as by processing such as fermentation and homogenization. These characteristics of dairy foods influence diverse pathways including related to mammalian target of rapamycin, silent information regulator transcript-1, angiotensin-converting enzyme, peroxisome proliferator-activated receptors, osteocalcin, matrix glutamate protein, hepatic de novo lipogenesis, hepatic and adipose fatty acid oxidation and inflammation, and gut microbiome interactions such as intestinal integrity and endotoxemia. The complexity of these emerging pathways and corresponding biological responses highlights the rapid advances in nutritional science and the continued need to generate robust empirical evidence on the mechanistic and clinical effects of specific foods.
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Affiliation(s)
- Dariush Mozaffarian
- From the Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.); and the George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (J.H.Y.W.).
| | - Jason H Y Wu
- From the Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.); and the George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (J.H.Y.W.)
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31
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Polyphenols and Oxidative Stress in Atherosclerosis-Related Ischemic Heart Disease and Stroke. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:8526438. [PMID: 29317985 PMCID: PMC5727797 DOI: 10.1155/2017/8526438] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/16/2017] [Accepted: 10/18/2017] [Indexed: 12/15/2022]
Abstract
Good nutrition could maintain health and life. Polyphenols are common nutrient mainly derived from fruits, vegetables, tea, coffee, cocoa, mushrooms, beverages, and traditional medicinal herbs. They are potential substances against oxidative-related diseases, for example, cardiovascular disease, specifically, atherosclerosis-related ischemic heart disease and stroke, which are health and economic problems recognized worldwide. In this study, we reviewed the risk factors for atherosclerosis, including hypertension, diabetes mellitus, hyperlipidemia, obesity, and cigarette smoking as well as the antioxidative activity of polyphenols, which could prevent the pathology of atherosclerosis, including endothelial dysfunction, low-density lipoprotein oxidation, vascular smooth muscle cell proliferation, inflammatory process by monocytes, macrophages or T lymphocytes, and platelet aggregation. The strong radical-scavenging properties of polyphenols would exhibit antioxidative and anti-inflammation effects. Polyphenols reduce ROS production by inhibiting oxidases, reducing the production of superoxide, inhibiting OxLDL formation, suppressing VSMC proliferation and migration, reducing platelet aggregation, and improving mitochondrial oxidative stress. Polyphenol consumption also inhibits the development of hypertension, diabetes mellitus, hyperlipidemia, and obesity. Despite the numerous in vivo and in vitro studies, more advanced clinical trials are necessary to confirm the efficacy of polyphenols in the treatment of atherosclerosis-related vascular diseases.
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32
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Identification of phenolic metabolites in human urine after the intake of a functional food made from grape extract by a high resolution LTQ-Orbitrap-MS approach. Food Res Int 2017; 100:435-444. [DOI: 10.1016/j.foodres.2017.01.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/20/2017] [Accepted: 01/24/2017] [Indexed: 01/16/2023]
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Wu JS, Kao MH, Tsai HD, Cheung WM, Chen JJ, Ong WY, Sun GY, Lin TN. Clinacanthus nutans Mitigates Neuronal Apoptosis and Ischemic Brain Damage Through Augmenting the C/EBPβ-Driven PPAR-γ Transcription. Mol Neurobiol 2017; 55:5425-5438. [PMID: 28942553 DOI: 10.1007/s12035-017-0776-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/15/2017] [Indexed: 02/07/2023]
Abstract
Clinacanthus nutans Lindau (C. nutans) is a traditional herbal medicine widely used in Asian countries for treating a number of remedies including snake and insect bites, skin rashes, viral infections, and cancer. However, the underlying molecular mechanisms for its action and whether C. nutans can offer protection on stroke damage in brain remain largely unknown. In the present study, we demonstrated protective effects of C. nutans extract to ameliorate neuronal apoptotic death in the oxygen-glucose deprivation model and to reduce infarction and mitigate functional deficits in the middle cerebral artery occlusion model, either administered before or after hypoxic/ischemic insult. Using pharmacological antagonist and siRNA knockdown approaches, we demonstrated ability for C. nutans extract to protect neurons and ameliorate ischemic injury through promoting the anti-apoptotic activity of peroxisome proliferator-activated receptor-gamma (PPAR-γ), a stress-induced transcription factor. Reporter and chromatin immunoprecipitation promoter analysis further revealed C. nutans extract to selectively increase CCAAT/enhancer binding protein (C/EBP)β binding to specific C/EBP binding site (-332~-325) on the PPAR-γ promoter to augment its transcription. In summary, we report a novel transcriptional activation involving C/EBPβ upregulation of PPAR-γ expression to suppress ischemic neuronal apoptosis and brain infarct. Recognition of C. nutans to enhance the C/EBPβ → PPAR-γ neuroprotective signaling pathway paves a new way for future drug development for prevention and treatment of ischemic stroke and other neurodegenerative diseases.
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Affiliation(s)
- Jui-Sheng Wu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, Republic of China
| | - Mei-Han Kao
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, Republic of China
| | - Hsin-Da Tsai
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, Republic of China
| | - Wai-Mui Cheung
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, Republic of China
| | - Jin-Jer Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, Republic of China
| | - Wei-Yi Ong
- Department of Anatomy, National University of Singapore, Singapore, Singapore
| | - Grace Y Sun
- Department of Biochemistry, University of Missouri, Columbia, MO, USA
| | - Teng-Nan Lin
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan, Republic of China. .,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Republic of China.
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Khan P, Rahman S, Queen A, Manzoor S, Naz F, Hasan GM, Luqman S, Kim J, Islam A, Ahmad F, Hassan MI. Elucidation of Dietary Polyphenolics as Potential Inhibitor of Microtubule Affinity Regulating Kinase 4: In silico and In vitro Studies. Sci Rep 2017; 7:9470. [PMID: 28842631 PMCID: PMC5573368 DOI: 10.1038/s41598-017-09941-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/01/2017] [Indexed: 02/08/2023] Open
Abstract
Microtubule affinity regulating kinase 4 (MARK4) is a Ser/Thr kinase belonging to AMPK-like family, has recently become an important drug target against cancer and neurodegenerative disorders. In this study, we have evaluated different natural dietary polyphenolics including rutin, quercetin, ferulic acid, hesperidin, gallic acid and vanillin as MARK4 inhibitors. All compounds are primarily binds to the active site cavity of MARK4. In silico observations were further complemented by the fluorescence-binding studies and isothermal titration calorimetry (ITC) measurements. We found that rutin and vanillin bind to MARK4 with a reasonably high affinity. ATPase and tau-phosphorylation assay further suggesting that rutin and vanillin inhibit the enzyme activity of MARK4 to a great extent. Cell proliferation, ROS quantification and Annexin-V staining studies are clearly providing sufficient evidences for the apoptotic potential of rutin and vanillin. In conclusion, rutin and vanillin may be considered as potential inhibitors for MARK4 and further exploited to design novel therapeutic molecules against MARK4 associated diseases.
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Affiliation(s)
- Parvez Khan
- Center for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Shafikur Rahman
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, 712-749, South Korea
| | - Aarfa Queen
- Center for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Saaliqa Manzoor
- Center for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Farha Naz
- Center for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Gulam Mustafa Hasan
- Department of Biochemistry, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Suaib Luqman
- CSIR-Central Institute of Medicinal and Aromatic Plants, Lucknow, 226015, India
| | - Jihoe Kim
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, 712-749, South Korea
| | - Asimul Islam
- Center for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Faizan Ahmad
- Center for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Md Imtaiyaz Hassan
- Center for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India.
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Sebastian RS, Wilkinson Enns C, Goldman JD, Moshfegh AJ. Dietary Flavonoid Intake Is Inversely Associated with Cardiovascular Disease Risk as Assessed by Body Mass Index and Waist Circumference among Adults in the United States. Nutrients 2017; 9:E827. [PMID: 28767062 PMCID: PMC5579620 DOI: 10.3390/nu9080827] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 11/17/2022] Open
Abstract
Although flavonoids may confer anti-inflammatory and anti-oxidant benefits, no research has examined if flavonoid intake is related to cardiovascular disease (CVD) risk defined by anthropometric measures in the USA population. This study sought to determine whether flavonoid intake is associated with combined body mass index (BMI) and waist circumference (WC) measures indicative of high, very high, or extremely high ("high+") risk for CVD, using one day of 24-h recall data from adult (≥20 years) participants in What We Eat in America, National Health and Nutrition Examination Survey 2007-2010. Individuals were divided into categories of intake of total flavonoids and each flavonoid class, and adjusted estimates of the percentages at high+ CVD risk (based on BMI and WC, as per National Heart, Lung, and Blood Institute guidelines) were calculated. Inverse linear trends were found in percentages of adults at high+ CVD risk by intake of total flavonoids, anthocyanidins, flavan-3-ols, and flavanones (p < 0.01). For individuals in the highest (versus the lowest) intake category of anthocyanidins, flavan-3-ols, and flavanones, relative risk and confidence intervals (RR and CI, respectively) were 0.86 (99% CI: 0.79, 0.93), 0.88 (99% CI: 0.79, 0.98), and 0.89 (99% CI: 0.80, 0.98), respectively. Research is needed to determine whether the inverse relationships found in this study are applicable to CVD endpoints at the population level.
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Affiliation(s)
- Rhonda S Sebastian
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
| | - Cecilia Wilkinson Enns
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
| | - Joseph D Goldman
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
| | - Alanna J Moshfegh
- USDA, Agricultural Research Service, Food Surveys Research Group, 10300 Baltimore Avenue, BARC-West, Bldg 005, Rm 102, Beltsville, MD 20705-2350, USA.
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Zhao CN, Meng X, Li Y, Li S, Liu Q, Tang GY, Li HB. Fruits for Prevention and Treatment of Cardiovascular Diseases. Nutrients 2017; 9:E598. [PMID: 28608832 PMCID: PMC5490577 DOI: 10.3390/nu9060598] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVDs) are leading global health problems. Accumulating epidemiological studies have indicated that consuming fruits was inversely related to the risk of CVDs. Moreover, substantial experimental studies have supported the protective role of fruits against CVDs, and several fruits (grape, blueberry, pomegranate, apple, hawthorn, and avocado) have been widely studied and have shown potent cardiovascular protective action. Fruits can prevent CVDs or facilitate the restoration of morphology and functions of heart and vessels after injury. The involved mechanisms included protecting vascular endothelial function, regulating lipids metabolism, modulating blood pressure, inhibiting platelets function, alleviating ischemia/reperfusion injury, suppressing thrombosis, reducing oxidative stress, and attenuating inflammation. The present review summarizes recent discoveries about the effects of fruits on CVDs and discusses potential mechanisms of actions based on evidence from epidemiological, experimental, and clinical studies.
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Affiliation(s)
- Cai-Ning Zhao
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xiao Meng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Ya Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Sha Li
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China.
| | - Qing Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Guo-Yi Tang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hua-Bin Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- South China Sea Bioresource Exploitation and Utilization Collaborative Innovation Center, Sun Yat-sen University, Guangzhou 510006, China.
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Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, Greenwood DC, Riboli E, Vatten LJ, Tonstad S. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol 2017; 46:1029-1056. [PMID: 28338764 PMCID: PMC5837313 DOI: 10.1093/ije/dyw319] [Citation(s) in RCA: 1284] [Impact Index Per Article: 160.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 12/23/2022] Open
Abstract
Background Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations. Methods PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included. Results For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90-0.94, I 2 = 0%, n = 15] for coronary heart disease, 0.84 (95% CI: 0.76-0.92, I 2 = 73%, n = 10) for stroke, 0.92 (95% CI: 0.90-0.95, I 2 = 31%, n = 13) for cardiovascular disease, 0.97 (95% CI: 0.95-0.99, I 2 = 49%, n = 12) for total cancer and 0.90 (95% CI: 0.87-0.93, I 2 = 83%, n = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Conclusions Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.
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Affiliation(s)
- Dagfinn Aune
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Bjørknes University College, Oslo, Norway
| | - Edward Giovannucci
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology
- Department of Nutrition, Harvard T. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lars T Fadnes
- Department of Global Public Health and Primary Care & Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - NaNa Keum
- Department of Epidemiology
- Department of Nutrition, Harvard T. Chan School of Public Health, Boston, MA, USA
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | | | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Lars J Vatten
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
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