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Donghia R, Tatoli R, Campanella A, Cuccaro F, Bonfiglio C, Giannelli G. Adding a Leafy Vegetable Fraction to Diets Decreases the Risk of Red Meat Mortality in MASLD Subjects: Results from the MICOL Cohort. Nutrients 2024; 16:1207. [PMID: 38674896 PMCID: PMC11053907 DOI: 10.3390/nu16081207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/08/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Dietary guidelines recommend limiting red meat intake because it has been amply associated with increased cancer mortality, particularly in patients with liver conditions, such as metabolic dysfunction-associated fatty liver disease (MASLD). MASLD is the leading cause of liver dysfunction in the world today, and no specific treatment other than lifestyle correction has yet been established. The aim of this study was to explore the protective role of leafy vegetables when associated with high red meat consumption. METHODS The study cohort included 1646 participants assessed during the fourth recall of the MICOL study, subdivided into two groups based on red meat intake (≤50 g/die vs. >50 g/die), in order to conduct a cancer mortality analysis. The prevalence of subjects that consumed >50 g/die was only 15.73%. Leafy vegetable intake was categorized based on median g/die consumption, and it was combined with red meat intake. CONCLUSIONS This is the first study to demonstrate that the consumption of about 30 g/die of leafy vegetables reduces the risk of mortality. A strong association with mortality was observed in subjects with MASLD, and the protective role of vegetables was demonstrated.
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Affiliation(s)
- Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (A.C.); (C.B.); (G.G.)
| | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (A.C.); (C.B.); (G.G.)
| | - Angelo Campanella
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (A.C.); (C.B.); (G.G.)
| | | | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (A.C.); (C.B.); (G.G.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (A.C.); (C.B.); (G.G.)
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Sewor C, Obeng AA, Eliason S, Agbeno EK, Amegah AK. Fruits and vegetables intake improves birth outcomes of women with gestational diabetes mellitus and hypertensive disorders of pregnancy. BMC Nutr 2024; 10:2. [PMID: 38167235 PMCID: PMC10763264 DOI: 10.1186/s40795-023-00814-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Disorders of pregnancy such as hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) have been associated with adverse birth outcomes. However, the ameliorating role of maternal nutrition in the relationship between disorders of pregnancy and adverse birth outcomes has received very little attention. We investigated the relationship between HDP and GDM, and adverse birth outcomes in a Ghanaian population and evaluated the effect modifying role of fruits and vegetables consumption in the relationship. METHODS We conducted a cross-sectional study among 799 mothers who had recently delivered singletons in the Cape Coast Metropolis, Ghana. Information on HDP, GDM and birth outcomes were retrieved from the maternal health book of the mothers. A food frequency questionnaire was used to assess fruits and vegetables intake during pregnancy. Modified Poisson regression was used to investigate the association between pregnancy disorders, and preterm birth (PTB) and low birth weight (LBW). Stratified analysis was used to assess the effect modifying role of fruits and vegetables consumption in the relationship. RESULTS The proportion of mothers with HDP and GDM was 11.3% and 7.5%, respectively. The proportion of the mothers with both conditions was 0.9%. The prevalence of PTB and LBW in the population was 27.9 and 7.3%, respectively. These disorders of pregnancy were associated with increased risk of PTB (Adjusted Prevalence Ration [APR] = 3.02; 95% CI: 2.42, 3.77) and LBW (APR = 5.32; 95% CI: 3.19, 8.88). In the stratified analysis, risk of PTB was higher among mothers classified in tertile I compared to mothers classified in tertiles II and III. For LBW, the risk increased with increasing fruits and vegetables consumption. The interaction p values were 0.0043 and 0.1604 for PTB and LBW, respectively. CONCLUSIONS We found mothers who were diagnosed with GDM and HDP to have increased risk of delivering a PTB and LBW baby. We also found fruits and vegetables consumption to modify the observed relationship. Mothers diagnosed with GDM and HDP should be advised during antenatal care visits to increase intake of fruits and vegetable consumption to help safeguard their health and that of the developing foetus.
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Affiliation(s)
- Christian Sewor
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Private Mail Bag, Cape Coast, Ghana
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
| | - Akua A Obeng
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Private Mail Bag, Cape Coast, Ghana
| | - Sebastian Eliason
- Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Evans K Agbeno
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - A Kofi Amegah
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Private Mail Bag, Cape Coast, Ghana.
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He Z, Jia Y, Li J, Cao J, Liu F, Li H, Chen J, Hu D, Shen C, Zhao Y, Liu X, Yu L, Huang J, Lu X, Gu D, Chen S. Fruit and vegetable intake and the risk of arterial hypertension in China: A prospective cohort study. Chronic Dis Transl Med 2023; 9:309-319. [PMID: 37915386 PMCID: PMC10617310 DOI: 10.1002/cdt3.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/13/2023] [Accepted: 05/19/2023] [Indexed: 11/03/2023] Open
Abstract
Background Population-based epidemiological evidence regarding the association between fruit and vegetable intake and the incidence of hypertension is inconsistent. This prospective cohort study aimed to investigate the association between fruit and vegetable intake and the risk of new-onset hypertension. Methods Based on the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR), 58,981 Chinese adults without hypertension at baseline were included. Information on fruit and vegetable intake was collected using a food-frequency questionnaire. Cox proportional hazards models were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident hypertension. Results During 640,795 person-years of follow-up, 21,008 new cases of hypertension were recorded. Compared with participants in the lowest quintile (Q1) of total fruit and vegetable (TFV) intake, the HRs (95% CIs) of incident hypertension were 0.90 (0.86-0.95), 0.85 (0.81-0.90), 0.82 (0.78-0.86), and 0.83 (0.78-0.88) for the Q2 to Q5 group (p trend < 0.001), respectively. In further analyses categorizing participants according to the recommended intake level (500 g/day), we found that increasing the intake of TFV, even though it was still insufficient for the recommendation, also had a protective effect against the incident hypertension. When considering the intake of fruit or vegetable separately, we found similar trends as the TFV intake. Conclusion These results suggest that a higher intake of fruit and vegetable is beneficial for preventing hypertension in Chinese adults.
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Affiliation(s)
- Zhi He
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Yanhui Jia
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Hongfan Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Jichun Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public HealthZhengzhou UniversityZhengzhouHenanChina
- Department of Biostatistics and Epidemiology, School of Public HealthShenzhen UniversityShenzhenGuangdongChina
| | - Chong Shen
- Department of Epidemiology and Biostatistics, Center for Global Health, School of Public HealthNanjing Medical UniversityNanjingJiangsuChina
| | - Yingxin Zhao
- Cardio‐Cerebrovascular Control and Research Center, Institute of Basic MedicineShandong First Medical University (Shandong Academy of Medicine Sciences)JinanShandongChina
| | - Xiaoqing Liu
- Division of EpidemiologyGuangdong Provincial People's Hospital and Cardiovascular InstituteGuangzhouGuangdongChina
| | - Ling Yu
- Department of CardiologyFujian Provincial HospitalFuzhouFujianChina
| | - Jianfeng Huang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Dongfeng Gu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Shufeng Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
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Tsiountsioura M, Cvirn G, Meixner-Goetz L, Ziegler T, Lamprecht M. Effects of long-term consumption of two plant-based dietary supplements on cardiovascular health and low-grade inflammation in middle-aged and elderly people: study protocol for a randomised, controlled trial. J Health Popul Nutr 2023; 42:100. [PMID: 37726820 PMCID: PMC10510179 DOI: 10.1186/s41043-023-00434-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/19/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Ageing is a process characterised by chronic low-grade inflammation and oxidative stress which could lead to increased prevalence of both physical and mental age-related chronic conditions. A healthy balanced diet, rich in fruit and vegetables as well as omega-3 polyunsaturated fatty acids (n3 PUFA), could reduce oxidative stress and improve markers of low-grade inflammation. Nonetheless, considering that a large part of the population struggles to meet current guidelines on fruit and vegetable and n3 PUFA recommendations, fruit and vegetable concentrate supplements and mixed omega fatty acid supplements could be an effective strategy to bridge the gap between actual and recommended intakes. METHODS In this randomised, controlled, open-labelled, parallel-grouped clinical trial, 112 participants will be allocated to one of four arms (n = 28 on each arm): an encapsulated juice powder concentrate, a plant-based omega fatty acid supplement, both or a control group. We aim to investigate whether long-term separate or combined ingestion of the two can affect biomarkers of cardiovascular health, low-grade inflammation and indicators of ageing, including cognitive function, in middle-aged and elderly people. We will additionally explore the effect of the different supplementations on plasma levels of vitamins, carotenoids and fatty acids. Intervention will last 2 years and participants will be assessed at baseline and at follow-up visits at 6, 12, 18 and 24 months. DISCUSSION This study will provide evidence whether long-term, plant-based dietary supplementation can support cardiovascular health, anti-inflammatory processes, immunity and nutritional status in ageing. Trial registration This trial was registered at ClinicalTrials.gov (NCT04763291) on February 21, 2021.
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Affiliation(s)
- Melina Tsiountsioura
- Juice Plus+ Science Institute, 140 Crescent Drive, Collierville, TN 38017 USA
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6/III, 8010 Graz, Austria
| | - Gerhard Cvirn
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6/III, 8010 Graz, Austria
| | - Lisa Meixner-Goetz
- Juice Plus+ Science Institute, 140 Crescent Drive, Collierville, TN 38017 USA
| | - Tobias Ziegler
- Juice Plus+ Science Institute, 140 Crescent Drive, Collierville, TN 38017 USA
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6/III, 8010 Graz, Austria
| | - Manfred Lamprecht
- Juice Plus+ Science Institute, 140 Crescent Drive, Collierville, TN 38017 USA
- Green Beat - Institute of Nutrient Research and Sport Nutrition, Nernstgasse 1, 8010 Graz, Austria
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Peña-Jorquera H, Cid-Jofré V, Landaeta-Díaz L, Petermann-Rocha F, Martorell M, Zbinden-Foncea H, Ferrari G, Jorquera-Aguilera C, Cristi-Montero C. Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome-A Comprehensive Review. Nutrients 2023; 15:3244. [PMID: 37513660 PMCID: PMC10386413 DOI: 10.3390/nu15143244] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
Atherosclerosis, chronic non-communicable diseases, and metabolic syndrome are highly interconnected and collectively contribute to global health concerns that reduce life expectancy and quality of life. These conditions arise from multiple risk factors, including inflammation, insulin resistance, impaired blood lipid profile, endothelial dysfunction, and increased cardiovascular risk. Adopting a plant-based diet has gained popularity as a viable alternative to promote health and mitigate the incidence of, and risk factors associated with, these three health conditions. Understanding the potential benefits of a plant-based diet for human health is crucial, particularly in the face of the rising prevalence of chronic diseases like diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Thus, this review focused on the plausible advantages of consuming a type of food pattern for the prevention and/or treatment of chronic diseases, emphasizing the dietary aspects that contribute to these conditions and the evidence supporting the benefits of a plant-based diet for human health. To facilitate a more in-depth analysis, we present separate evidence for each of these three concepts, acknowledging their intrinsic connection while providing a specific focus on each one. This review underscores the potential of a plant-based diet to target the underlying causes of these chronic diseases and enhance health outcomes for individuals and populations.
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Affiliation(s)
- Humberto Peña-Jorquera
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Viña del Mar 2530388, Chile
| | - Valeska Cid-Jofré
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago 9160019, Chile
| | - Leslie Landaeta-Díaz
- Facultad de Salud y Ciencias Sociales, Universidad de las Américas, Santiago 7500975, Chile
- Núcleo en Ciencias Ambientales y Alimentarias, Universidad de las Américas, Santiago 7500975, Chile
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, Centre for Healthy Living, University of Concepción, Concepción 4070386, Chile
| | - Hermann Zbinden-Foncea
- Laboratorio de Fisiología del Ejercicio y Metabolismo, Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago 7500000, Chile
- Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Gerson Ferrari
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Av. Pedro de Valdivia 425, Providencia 7500912, Chile
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 9170022, Chile
| | - Carlos Jorquera-Aguilera
- Escuela de Nutrición y Dietética, Facultad de Ciencias, Universidad Mayor, Santiago 8580745, Chile
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Viña del Mar 2530388, Chile
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Ilesanmi-Oyelere BL, Kruger MC. Associations between dietary patterns and an array of inflammation biomarkers and plasma lipid profile in postmenopausal women. BMC Womens Health 2023; 23:256. [PMID: 37173732 PMCID: PMC10176721 DOI: 10.1186/s12905-023-02417-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE AND DESIGN In this cross-sectional study, evaluation of the association between four dietary patterns, nutrients and food intakes and an array of systemic inflammation biomarkers and lipid profile among 80 New Zealand postmenopausal women were conducted. MATERIALS Eighty postmenopausal women participated in the study. A validated food frequency questionnaire was used to collect nutrients and food intake. Four dietary patterns were identified by principal component analysis (PCA) and plasma samples collected for inflammatory biomarkers and lipid profile measures. RESULTS There were negative correlations between intake of dietary fibre, soluble and insoluble non-starch polysaccharides (NSP), vitamin C and niacin and with almost all the inflammatory markers for the whole group. Vegetables, tea/coffee and especially fruit intake were negatively correlated with the inflammatory biomarkers in the whole group. A high intake of Pattern 1 (potato, bread, and fruit pattern) was associated with a low risk of high interferon (IFN)-α2, IFN-λ, interleukin (IL)-6 and IL-8 levels while a high intake of Pattern 3 (fast-food pattern) was associated high risk of IFN-α2 levels. Multiple linear regression showed a negative correlation between Pattern 2 (soups and vegetables pattern) and levels of C-reactive protein (CRP) as well as ferritin. A positive association was observed between Pattern 3 (fast-food pattern) and CRP levels. Positive correlation was also observed between Pattern 2 and high-density lipoprotein (HDL) and total cholesterol (TC) levels, Pattern 4 (meat and vegetables pattern) was however negatively correlated with TC, low-density lipoprotein (LDL) and TC/HDL ratio. CONCLUSIONS The result of this study reinforces the contribution and role of diet in modifying inflammation in postmenopausal women.
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Affiliation(s)
- Bolaji L Ilesanmi-Oyelere
- School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand.
- Human Nutrition and Dietetics Department, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates.
| | - Marlena C Kruger
- School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
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Mohajeri M, Cicero AFG. Adherence to the Mediterranean Diet Association with Serum Levels of Nitric Oxide, Prostacyclin, and Thromboxane B 2 among Prinzmetal Angina Patients and Healthy Persons. Nutrients 2023; 15:nu15030738. [PMID: 36771443 PMCID: PMC9919954 DOI: 10.3390/nu15030738] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/21/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
This study aimed to assess the association between adherence to the Mediterranean diet with serum Nitric oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal angina patients and healthy persons. This case-control study was conducted among 100 Prinzmetal angina patients and 100 healthy persons referred to the Ardabil Imam Khomeini hospital between 2021 and 2022. Blood samples were obtained from all study participants for measurement of serum Nitric oxide, Prostacyclin, and Thromboxane B2. To calculate adherence to the Mediterranean diet, the ten-item screener was used. The serum Nitric oxide in patients who adhered more to the Mediterranean diet was higher than patients with less adherence (coeff. = 0.41 p = 0.04). The serum Prostacyclin level in patients with greater adherence to the Mediterranean diet was 0.34 units higher than patients with less adherence (coeff. = 0.34 p = 0.02). The level of serum Thromboxane B2 had a negative association with adherence to the Mediterranean diet (coeff. = -0.48 p = 0.04). The amount of consumption of olive oil, fruits, vegetables, and legumes in healthy people was more than Prinzmetal angina patients. In Prinzmetal angina patients, more adherence to the Mediterranean diet can decrease the serum Thromboxane B2 and increase the serum Nitric oxide and Prostacyclin.
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Affiliation(s)
- Mahsa Mohajeri
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil 56131-56491, Iran
- Correspondence: or mahsa. (M.M.); (A.F.G.C.); Tel.: +98-9143592794 (M.M.); +39-512142224 (A.F.G.C.)
| | - Arrigo F. G. Cicero
- Medicine and Surgery Sciences Department, Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy
- IRCCS AOU S. Orsola-Malpighi University Hospital, 40123 Bologna, Italy
- Correspondence: or mahsa. (M.M.); (A.F.G.C.); Tel.: +98-9143592794 (M.M.); +39-512142224 (A.F.G.C.)
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Ambroselli D, Masciulli F, Romano E, Catanzaro G, Besharat ZM, Massari MC, Ferretti E, Migliaccio S, Izzo L, Ritieni A, Grosso M, Formichi C, Dotta F, Frigerio F, Barbiera E, Giusti AM, Ingallina C, Mannina L. New Advances in Metabolic Syndrome, from Prevention to Treatment: The Role of Diet and Food. Nutrients 2023; 15:640. [PMID: 36771347 PMCID: PMC9921449 DOI: 10.3390/nu15030640] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
The definition of metabolic syndrome (MetS) has undergone several changes over the years due to the difficulty in establishing universal criteria for it. Underlying the disorders related to MetS is almost invariably a pro-inflammatory state related to altered glucose metabolism, which could lead to elevated cardiovascular risk. Indeed, the complications closely related to MetS are cardiovascular diseases (CVDs) and type 2 diabetes (T2D). It has been observed that the predisposition to metabolic syndrome is modulated by complex interactions between human microbiota, genetic factors, and diet. This review provides a summary of the last decade of literature related to three principal aspects of MetS: (i) the syndrome's definition and classification, pathophysiology, and treatment approaches; (ii) prediction and diagnosis underlying the biomarkers identified by means of advanced methodologies (NMR, LC/GC-MS, and LC, LC-MS); and (iii) the role of foods and food components in prevention and/or treatment of MetS, demonstrating a possible role of specific foods intake in the development of MetS.
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Affiliation(s)
- Donatella Ambroselli
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizio Masciulli
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Enrico Romano
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppina Catanzaro
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Maria Chiara Massari
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Elisabetta Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Health Sciences Section, University “Foro Italico”, 00135 Rome, Italy
| | - Luana Izzo
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Alberto Ritieni
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
- UNESCO, Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy
| | - Michela Grosso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Caterina Formichi
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Francesco Dotta
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Francesco Frigerio
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Eleonora Barbiera
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Giusti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Cinzia Ingallina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Luisa Mannina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
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Akhavanfar R, Hojati A, Kahrizi MS, Farhangi MA, Ardekani AM. Adherence to lifelines diet score and risk factors of metabolic syndrome among overweight and obese adults: A cross-sectional study. Front Nutr 2022; 9:961468. [PMID: 36466413 PMCID: PMC9713010 DOI: 10.3389/fnut.2022.961468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 11/02/2022] [Indexed: 09/28/2023] Open
Abstract
Background Metabolic syndrome (MetS) is one of the most significant public health issues worldwide, and diet quality is an important controllable environmental factor influencing the incidence of MetS. Numerous dietary scores have been established to assess compliance with dietary recommendations or eating patterns, many of which are not entirely food-based. Hence, Lifelines Diet Score (LLDS) was developed in response to the shortcomings of existing tools. This study aimed to assess any possible links between total food quality and cardiometabolic risk factors among overweight and obese adults. Methods This cross-sectional study included 338 overweight and obese individuals [body mass index (BMI) > 25 kg/m2] aged 20-50 years in Tabriz, Iran. To collect dietary data, we used a validated semi-quantitative Food Frequency Questionnaire (FFQ) for Iranian population. Enzymatic-colorimetric methods were used to assess serum glucose and lipids, and enzyme-linked immunosorbent assay (ELISA) kits were used to measure insulin levels. In addition, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. Results BMI and hip circumference (HC) were significantly different (P < 0.05) amongst LLDS tertiles. Adherence to the highest tertile of LLDS was associated with lower SBP, and the subjects in higher LLDS tertiles significantly had lower systolic blood pressure (SBP) (P = 0.04). Triglyceride (TG) levels were also lower in the third tertile of LLDS with a near-significant P-value (P = 0.05). Conclusion According to our results, a higher diet quality score, determined by LLDS, can be associated with a lower risk of MetS. Further experimental and longitudinal studies are needed to better understand this relationship.
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Affiliation(s)
- Roozbeh Akhavanfar
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Hojati
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Abnoos Mokhtari Ardekani
- Endocrinoligy and Metabolism Research Center, Institute of Basic and Clinical Physiology Science and Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Mayra ST, Chondropoulos K, De Leon A, Kravat N, Johnston CS. The feasibility and preliminary efficacy of early time-restricted eating on diet quality in college students: A randomized study. Obes Res Clin Pract 2022; 16:413-420. [DOI: 10.1016/j.orcp.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 08/08/2022] [Accepted: 08/29/2022] [Indexed: 11/07/2022]
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Tan L, Lim G, Koo H, Ismail M, Chan Y, Sulaiman W, Ali O, Kee C, Omar M. Association between Adequate Fruit and Vegetable Intake and CVDs-Associated Risk Factors among the Malaysian Adults: Findings from a Nationally Representative Cross-Sectional Study. IJERPH 2022; 19:9173. [PMID: 35954528 PMCID: PMC9368066 DOI: 10.3390/ijerph19159173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 02/05/2023]
Abstract
This study aimed to investigate the relationship between adequate fruit and vegetable intake, and cardiovascular diseases (CVDs)-associated risk factors (i.e., diabetes, hypertension and hypercholesterolemia) among Malaysian adults without history of chronic diseases. We analyzed the data from 11,172 Malaysian adults (i.e., 5554 male and 5618 female), who participated in the population-based National Health and Morbidity Survey 2015. Multiple logistic regression was employed to determine the relationship between adequate daily intake of fruit and vegetables (i.e., ≥5 servings per day) and undiagnosed diabetes, undiagnosed hypertension, and undiagnosed hypercholesterolemia, after adjustment for sociodemographic characteristics and lifestyle risk factors. The mean age (±SE) of these participants was 40.79 (±0.17) years old. Our data demonstrated an adequate daily intake of fruit and vegetables was inversely associated with undiagnosed hypercholesterolemia (adjusted OR: 0.71; 95% CI: 0.51–0.98). Further analyses demonstrated an inverse association between the adequate daily intake of vegetables alone and undiagnosed hypertension (adjusted OR: 0.71; 95% CI: 0.51–0.98). The findings from this study suggest the need for a holistic public health approach to reinforce public awareness about diet-related diseases, which will eventually aid in the prevention of CVDs among Malaysian adults in the long run.
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Li L, Shan Z, Wan Z, Li R, Geng T, Lu Q, Zhu K, Qiu Z, Zhang X, Liu Y, Liu L, Pan A, Liu G. Associations of lower-carbohydrate and lower-fat diets with mortality among people with prediabetes. Am J Clin Nutr 2022; 116:206-215. [PMID: 35421220 DOI: 10.1093/ajcn/nqac058] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although low-carbohydrate and low-fat diets are beneficial in short-term metabolic improvement, the associations of these dietary patterns, particularly with different food sources and quality of macronutrients, with mortality remain unclear among people with prediabetes. OBJECTIVES We aimed to examine the associations of different types of lower-carbohydrate diets (LCDs) and lower-fat diets (LFDs) with mortality among individuals with prediabetes. METHODS This study included 9793 adults with prediabetes from the NHANES 1999-2014. Mortality status was linked to National Death Index mortality data through 31 December, 2015. Overall, unhealthy, and healthy LCD and LFD scores were determined based on the percentages of energy from total and subtypes of carbohydrate, fat, and protein. Cox proportional hazards regression models were applied to calculate HRs and 95% CIs. RESULTS Higher healthy LCD score was associated with favorable blood glucose, insulin, HOMA-IR, C-reactive protein (CRP), and blood lipids, whereas higher healthy LFD score was associated with lower blood glucose and CRP at baseline (all P-trend < 0.05). During 72,054 person-years of follow-up, 1352 deaths occurred. The multivariate-adjusted HRs (95% CIs) of all-cause mortality per 20-percentile increment in dietary scores were 0.88 (0.80, 0.96) for healthy LCD score (P = 0.003), 0.85 (0.78, 0.93) for healthy LFD score (P < 0.001), 1.09 (0.99, 1.21) for unhealthy LCD score (P = 0.08), and 1.11 (1.00, 1.22) for unhealthy LFD score (P = 0.05). Isocalorically replacing 3%-5% energy of low-quality carbohydrate or saturated fat with high-quality carbohydrate, plant-based protein, or unsaturated fat was associated with a 14%-37% reduced all-cause mortality. CONCLUSIONS Healthy LCD and LFD scores were significantly associated with lower all-cause mortality, whereas unhealthy LCD and LFD scores tended to be associated with higher all-cause mortality, among people with prediabetes.
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Affiliation(s)
- Lin Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Geng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zixin Qiu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuena Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yujie Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Murphy R, Al Rasheed A, Keaver L. Effect of a brief dietary counselling intervention on emergency department cardiac chest pain presentations. BMJ Nutr Prev Health 2022; 5:159-163. [PMID: 36619327 PMCID: PMC9813630 DOI: 10.1136/bmjnph-2021-000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/20/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction 15% of all presentations to our emergency department last year were chest pain related. This presented an opportunity to evaluate the impact of a brief physician counselling intervention on patient-reported changes in cardio-protective foodstuff intake. Methods This is a prospective non-randomised before and after comparison study without controls, conducted between an emergency department presentation and a scheduled follow-up visit at a cardiac diagnostics department. Participants were recruited between February and March 2021. The selected dietary components for inclusion after review of the literature were green leafy vegetables, other coloured vegetables, wholegrains, legumes and fruits. A food frequency questionnaire was completed by patients before and after a physician counselling intervention aided by a dietary infographic. Additionally, using the transtheoretical model for health behaviour change, we assessed each patient's evolution during the study. Results 38 patients were recruited. For patients with total baseline consumptions of five or fewer per day, there was an increase in cardioprotective foodstuff intakes (z=-2.784 p<0.005 effect size 0.39). Corresponding to this, there was a participant shift observed towards the action and maintenance phases of behaviour change from the contemplation and preparation phases. Discussion We demonstrated a statistically significant change with moderate effect size using a simple infographic, coupled with brief physician counselling, to promote increased intake of cardioprotective foodstuffs by patients with poor baseline intakes (<5 cardio-protective foods per day) and known modifiable risk factors for ischaemic heart disease. Conclusion Diet is one arm in the prevention of cardiovascular disease that is often neglected by physicians. This study found that a brief dietary counselling intervention applied in an emergency department setting, administered by non-nutritionists can have a role in changing patient dietary behaviour.
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Affiliation(s)
- Ronan Murphy
- Emergency Department, Sligo University Hospital, Sligo, Ireland
| | | | - Laura Keaver
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland,Health and Biomedical (HEAL) Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
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Pu L, Zhang R, Wang X, Zhao T, Sun H, Han L. Associations of Serum Biomarkers of Fruit and Vegetable Intake With the Risk of Cause–Specific Mortality and All–Cause Mortality: A National Prospective Cohort Study. Front Nutr 2022; 9:874943. [PMID: 35634408 PMCID: PMC9134271 DOI: 10.3389/fnut.2022.874943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/06/2022] [Indexed: 11/22/2022] Open
Abstract
Objective The purpose of this study was to evaluate the associations of serum biomarkers of fruit and vegetable intake (vitamin C and carotenoids) with cause–specific mortality and all–cause mortality in a nationally representative sample of US adults. Methods We analyzed data from 12,530 participants from the National Health and Nutrition Examination Survey III (1988–1994). The Cox proportional hazards models with restricted cubic spline were used for the analysis. Results During 246,027 person–years of follow–up, 4,511 deaths occurred, including 1,395 deaths from cardiovascular disease, 1,072 deaths from heart disease, 323 deaths from cerebral disease, and 954 deaths from cancer. The serum vitamin C was significantly associated with the cancer and all–cause mortality, with hazard ratios (HRs) (95% CIs) for each one SD of 0.80 (0.71–0.91) and 0.91 (0.86–0.96). The serum alpha–carotene was significantly associated with the cancer mortality, with HRs (95% CIs) of 0.70 (0.54–0.90), 0.68 (0.48–0.95), 0.64 (0.43–0.95), and 0.44 (0.33–0.60) for comparisons of groups 2–5 with group 1 in model 2, respectively. The change for each one SD in the composite biomarker score, equivalent to a 0.483 times/month difference in total fruits and vegetables intake, gave an HR of 0.79 (0.69–0.90) for cancer mortality. Conclusion Inverse associations were found between serum vitamin C, carotenoids, and composite biomarker score and outcomes expect for cerebral disease, heart disease, and cardiovascular disease mortality. This finding supports an increase in dietary fruit and vegetable intake as a primary prevention strategy for cancer and all–cause mortality.
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Affiliation(s)
- Liyuan Pu
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Ruijie Zhang
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Xiaojie Wang
- Department of Neurology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Tian Zhao
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Hongpeng Sun
- Department of Child and Adolescent Health and Social Medicine, School of Public Health, Medical College of Soochow University, Suzhou, China
- *Correspondence: Hongpeng Sun
| | - Liyuan Han
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
- Liyuan Han
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Poorolajal J, Mohammadi Y, Doosti-Irani A, Khosh-Manesh S. The contribution of avoidable factors in doubling or halving the odds of hypertension. PLoS One 2022; 17:e0266689. [PMID: 35390081 PMCID: PMC8989301 DOI: 10.1371/journal.pone.0266689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Despite the well-known impact of fruit/vegetable consumption, physical activity, body mass index, waist-hip ratio, fasting blood glucose, and total cholesterol on blood pressure, the amount of exposure to these factors is required to halve or double the odds of hypertension is unknown, but it was investigated in this research. Methods The data used in this study are derived from results of the seventh Iranian national STEPS survey involving 30,542 adults aged 18 years or older. The questionnaire measured non-communicable disease risk factors covered three different levels including behavioral characteristics, physical and biochemical measurements. The level of exposure to factors necessary to reach the odds ratio of 0.5 or odds ratio of 2.0 was obtained from the coefficients of the multiple logistic regression model. Results An OR of 0.5 corresponds to 7 servings of fruit and vegetable consumption daily and burning of 7175 kcal through physical activity at work or recreation daily. An OR of 2.0 corresponds to an increase in body mass index of about 11 kg/m2, an increase in the waist-hip ratio of about 18%, an increase in fasting blood glucose of about 77 mg/dl, and an increase in total cholesterol of about 134 mg/dl. Conclusion The results of this study indicate how much fruit and vegetable and physical activity halve the odds of hypertension and how much increase in body mass index, the waist-hip ratio, fasting blood glucose, and total cholesterol can double the odds of hypertension. Such information may be useful for developing guidelines by policymakers.
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Affiliation(s)
- Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saman Khosh-Manesh
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- * E-mail:
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Abou Baker DH. An ethnopharmacological review on the therapeutical properties of flavonoids and their mechanisms of actions: A comprehensive review based on up to date knowledge. Toxicol Rep 2022; 9:445-469. [PMID: 35340621 PMCID: PMC8943219 DOI: 10.1016/j.toxrep.2022.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 12/11/2022] Open
Abstract
Flavonoids -a class of low molecular weight secondary metabolites- are ubiquitous and cornucopia throughout the plant kingdom. Structurally, the main structure consists of C6-C3-C6 rings with different substitution patterns so that many sub-classes are obtained, for example: flavonols, flavonolignans, flavonoid glycosides, flavans, anthocyanidins, aurones, anthocyanidins, flavones, neoflavonoids, chalcones, isoflavones, flavones and flavanones. Flavonoids are evaluated to have drug like nature since they possess different therapeutic activities, and can act as cardioprotective, antiviral, antidiabetic, anti-inflammatory, antibacterial, anticancer, and also work against Alzheimer's disease and others. However, information on the relationship between their structure and biological activity is scarce. Therefore, the present review tries to summarize all the therapeutic activities of flavonoids, their mechanisms of action and the structure activity relationship. Latest updated ethnopharmacological review of the therapeutic effects of flavonoids. Flavonoids are attracting attention because of their therapeutic properties. Flavonoids are valuable candidates for drug development against many dangerous diseases. This overview summarizes the most important therapeutic effect and mechanism of action of flavonoids. General knowledge about the structure activity relationship of flavonoids is summarized. Substitution of chemical groups in the structure of flavonoids can significantly change their biological and chemical properties. The chemical properties of the basic flavonoid structure should be considered in a drug-based structural program.
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Ansari B, Aschner M, Hussain Y, Efferth T, Khan H. Suppression of colorectal carcinogenesis by naringin. Phytomedicine 2022; 96:153897. [PMID: 35026507 DOI: 10.1016/j.phymed.2021.153897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/13/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Colorectal cancer is the third most malignant cancer worldwide. Despite novel treatment options, the incidence and mortality rates of colon cancer continue to increase in most countries, especially in US, European and Asian countries. Colorectal carcinogenesis is multifactorial, including dietary and genetic factors, as well as lacking physical activity. Vegetables and fruits contain high amounts of secondary metabolites, which might reduce the risk for colorectal carcinogenesis. Flavonoids are important bioactive polyphenolic compounds. There are more than 4,000 different flavonoids, including flavanones, flavonoids, isoflavonoids, flavones, and catechins in a large variety of plant. HYPOTHESIS Among various other flavonoids, naringin in Citrus fruits has been a subject of intense scrutiny for its activity against many types of cancer, including colorectal cancer. We hypothesize that naringin is capable to inhibit the growth of transformed colonocytes and to induce programmed cell death in colon cancer cells. RESULTS We comprehensively review the inhibitory effects of naringin on colorectal cancers and address the underlying mechanistic pathways such as NF-κB/IL-6/STAT3, PI3K/AKT/mTOR, apoptosis, NF-κB-COX-2-iNOS, and β-catenin pathways. CONCLUSION Naringin suppresses colorectal inflammation and carcinogenesis by various signaling pathways. Randomized clinical trials are needed to determine their effectiveness in combating colorectal cancer.
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Affiliation(s)
- Bushra Ansari
- Department of Pharmacy, Abdul Wali Khan University Mardan 23200, Pakistan
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Yaseen Hussain
- College of Pharmaceutical Sciences, Soochow University, Jiangsu, 221400, P R China
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University Staudinger Weg 5, 55128 Mainz, Germany
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan 23200, Pakistan
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Chibisov S, Kharlitskaya E, Singh RB, Itharat A, On-Saard E, Park HR, Chaudhury J, Chakravorty S, Gupta OK, Smail MM. Polyphenolics and flavonoids in health and diseases. Functional Foods and Nutraceuticals in Metabolic and Non-Communicable Diseases 2022:671-689. [DOI: 10.1016/b978-0-12-819815-5.00016-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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García-Cordero J, Pino A, Cuevas C, Puertas-Martín V, San Román R, de Pascual-Teresa S. Neurocognitive Effects of Cocoa and Red-Berries Consumption in Healthy Adults. Nutrients 2021; 14:1. [PMID: 35010877 PMCID: PMC8746322 DOI: 10.3390/nu14010001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/13/2021] [Accepted: 12/18/2021] [Indexed: 01/04/2023] Open
Abstract
In recent decades, the elderly population has increased at higher rates than any other population group, resulting in an increase in age-related diseases such as neurodegenerative and cognitive impairment. To address this global health problem, it is necessary to search for new dietary strategies that can prevent the main neurocognitive problems associated with the ageing process. Therefore, the aim of the present study was to analyze the effect of cocoa flavanols and red berry anthocyanins on brain-derived neurotrophic factor (BDNF) and nerve growth factor receptor (NGF-R) and to stablish the possible improvement in cognitive performance by using a battery of neurocognitive tests that included the Verbal Learning Test Spain-Complutense, the Spatial Recall Test 10/36 BRB-N, the Wechsler Adult Intelligence Scale III and IV, the STROOP Task and the Tower of London Test. A randomized, double-blind, parallel-group study was performed in 60 healthy volunteers between 50 and 75 years old who consumed a cocoa powder, a red berries mixture or a combination of both for 12 weeks. After the intervention, we observed a reduction in the time needed to start (p = 0.031) and finish (p = 0.018) the neurocognitive test known as the Tower of London in all groups, but the decrease in time to finish the task was more pronounced in the intervention with the combination of cocoa-red berries group. We failed to show any significant difference in BDNF and NGF-R sera levels. However we found a negative correlation between BDNF and the number of movements required to finish the TOL in women (p = 0.044). In conclusion, our study showed an improvement in executive function, without any change in neurotrofin levels, for all intervention arms.
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Affiliation(s)
- Joaquín García-Cordero
- Departamento de Metabolismo y Nutrición, Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain; (J.G.-C.); (A.P.)
| | - Alicia Pino
- Departamento de Metabolismo y Nutrición, Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain; (J.G.-C.); (A.P.)
| | - Constanza Cuevas
- Hospital 12 de Octubre, 28041 Madrid, Spain; (C.C.); (V.P.-M.); (R.S.R.)
| | - Verónica Puertas-Martín
- Hospital 12 de Octubre, 28041 Madrid, Spain; (C.C.); (V.P.-M.); (R.S.R.)
- Facultad de Educación, Universidad Internacional de la Rioja, 26006 Logrono, Spain
| | - Ricardo San Román
- Hospital 12 de Octubre, 28041 Madrid, Spain; (C.C.); (V.P.-M.); (R.S.R.)
| | - Sonia de Pascual-Teresa
- Departamento de Metabolismo y Nutrición, Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain; (J.G.-C.); (A.P.)
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Amiri M, Karabegović I, van Westing AC, Verkaar AJCF, Beigrezaei S, Lara M, Bramer WM, Voortman T. Whole-diet interventions and cardiovascular risk factors in postmenopausal women: A systematic review of controlled clinical trials. Maturitas 2021; 155:40-53. [PMID: 34876248 DOI: 10.1016/j.maturitas.2021.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Menopause is accompanied by many metabolic changes, increasing the risk of cardiometabolic diseases. The impact of diet, as a modifiable lifestyle factor, on cardiovascular health in general populations has been well established. The purpose of this systematic review is to summarize the evidence on the effects of whole diet on lipid profile, glycemic indices, and blood pressure in postmenopausal women. METHODS Embase, Medline, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from inception to February 2021. We included controlled clinical trials in postmenopausal women that assessed the effect of a whole-diet intervention on lipid profile, glycemic indices, and/or blood pressure. The risk of bias in individual studies was assessed using RoB 2 and ROBINS-I tools. SUMMARY OF EVIDENCE Among 2,134 references, 21 trials met all eligibility criteria. Overall, results were heterogenuous and inconsistent. Compared to control diets, some studies showed that participants experienced improvements in total cholesterol (TC), low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), fasting blood sugar (FBS), and apolipoprotein A (Apo-A) after following fat-modified diets, but some adverse effects on triglycerides (TG), very low-density lipoprotein cholesterol (VLDL), lipoprotein(a) (Lp(a)), and high-density lipoprotein cholesterol (HDL) concentrations were also observed. A limited number of trials found some effects of the Paleolithic, weight-loss, plant-based, or energy-restricted diets, or of following American Heart Association recommendations on TG, TC, HDL, insulin, FBS, or insulin resistance. CONCLUSION Current evidence suggests that diet may affect levels of some lipid profile markers, glycemic indices, and blood pressure among postmenopausal women. However, due to the large heterogeneity in intervention diets, comparison groups, intervention durations, and population characteristics, findings are inconclusive. Further well-designed clinical trials are needed on dietary interventions to reduce cardiovascular risk in postmenopausal women.
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Affiliation(s)
- Mojgan Amiri
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Irma Karabegović
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Anniek C van Westing
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Auke J C F Verkaar
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Sara Beigrezaei
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Macarena Lara
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
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21
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Ghoreishy SM, Asoudeh F, Jayedi A, Mohammadi H. Fruit and vegetable intake and risk of frailty: A systematic review and dose response meta-analysis. Ageing Res Rev 2021; 71:101460. [PMID: 34534684 DOI: 10.1016/j.arr.2021.101460] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/19/2021] [Accepted: 09/11/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE This systematic review and dose-response meta-analysis of observational studies was conducted to summarize available findings on the association between fruits and vegetables (FVs) consumption and risk of frailty. METHODS Online databases including Medline, Scopus, and Embase were searched to detect related publications up to February 2021. Study selection and data extraction were performed by two investigators working in parallel. In most included studies, frailty was defined according to the Fried criteria. Overall, 14 articles with 18,616 subjects with frailty and 101,969 controls were included. To combined data, a random effect model was used. Dose-response associations were also evaluated. RESULTS Fourteen studies (10 cohorts and four cross-sectional) were included. Pooled effect size for the highest versus lowest category of FVs consumption showed an inverse association with risk of frailty (RR cohort = 0.65; 95% CI: 0.50-0.84; I2 = 81%, n = 7). Every one serving (200 g) per day increment in FVs intake was associated with a 14% lower risk of frailty. The risk of frailty decreased linearly up to FVs consumption of 3.5 servings/d, with flattening the curve at higher intake. Pooled analysis regarding fruits and vegetables separately did not indicate a significant association with the risk of frailty. Indeed, the results of the meta-analysis correspond only to the cohort studies. Based on the NutriGrade score, the quality of evidence for a protective effect of FV on frailty was "moderate". CONCLUSIONS FVs consumption was associated with a decreased risk of frailty. Further large-scale prospective cohort studies are needed to reach more confident conclusions.
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22
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Condezo-Hoyos L, Gazi C, Pérez-Jiménez J. Design of polyphenol-rich diets in clinical trials: A systematic review. Food Res Int 2021; 149:110655. [PMID: 34600657 DOI: 10.1016/j.foodres.2021.110655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/27/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022]
Abstract
Most randomized clinical trials of polyphenols focus on individual foods. Nevertheless, due to their presence in many foods and in order to reflect a real situation, clinical trials based on polyphenol-rich diets are particularly important. This systematic review explores the characteristics of the polyphenol-rich diets used in intervention studies. The bibliography search for English-language scientific papers was performed in the Elsevier Scopus Database and PUBMED in March 2020, and focused on intervention studies with whole polyphenol-rich diets, establishing several exclusion criteria. In studies fulfilling the requirements, information on the design of the polyphenol-rich diet and associated polyphenol intake was extracted and compared. A total of 5 studies were selected. Among them, substantial differences were found in the design of the polyphenol-rich diets, regarding specific instructions and concerning the foods provided. Similarly, although a median daily polyphenol intake of 2,564 mg/day (17,945 mg/week) was obtained from the studies, which corresponds to a nutritional dose, intake values varied widely both for total polyphenols (the difference between studies reached threefold), and for individual polyphenol intake (for hydroxycinnamic acids, a tenfold difference was found between percentile 25 and percentile 75 values). These differences made the comparison of results difficult and may affected the observed health effects. Thus, despite the relevance of studying polyphenol-rich diets as a whole, this systematic review found substantial differences between the studies performed, making direct comparisons difficult.
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Affiliation(s)
- Luis Condezo-Hoyos
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Madrid, Spain; Universidad Nacional Agraria la Molina, Facultad de Industrias Alimentarias, Innovative Technology, Food and Health Research Group, La Molina, Lima, Perú
| | - Christina Gazi
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Madrid, Spain
| | - Jara Pérez-Jiménez
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Madrid, Spain.
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23
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Gardener SL, Rainey-Smith SR, Weinborn M, Bondonno CP, Martins RN. Intake of Products Containing Anthocyanins, Flavanols, and Flavanones, and Cognitive Function: A Narrative Review. Front Aging Neurosci 2021; 13:640381. [PMID: 34539375 PMCID: PMC8446387 DOI: 10.3389/fnagi.2021.640381] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this review is to examine human research studies published within the past 6 years which evaluate the role of anthocyanin, flavanol, and flavanone consumption in cognitive function, and to discuss potential mechanisms of action underlying any observed benefits. Evidence to date suggests the consumption of flavonoid-rich foods, such as berries and cocoa, may have the potential to limit, or even reverse, age-related declines in cognition. Over the last 6 years, the flavonoid subgroups of anthocyanins, flavanols, and flavanones have been shown to be beneficial in terms of conferring neuroprotection. The mechanisms by which flavonoids positively modulate cognitive function are yet to be fully elucidated. Postulated mechanisms include both direct actions such as receptor activation, neurotrophin release and intracellular signaling pathway modulation, and indirect actions such as enhancement of cerebral blood flow. Further intervention studies conducted in diverse populations with sufficient sample sizes and long durations are required to examine the effect of consumption of flavonoid groups on clinically relevant cognitive outcomes. As populations continue to focus on adopting healthy aging strategies, dietary interventions with flavonoids remains a promising avenue for future research. However, many questions are still to be answered, including identifying appropriate dosage, timeframes for intake, as well as the best form of flavonoids, before definitive conclusions can be drawn about the extent to which their consumption can protect the aging brain.
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Affiliation(s)
- Samantha L Gardener
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
| | - Stephanie R Rainey-Smith
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.,School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
| | - Michael Weinborn
- School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, Royal Perth Hospital, The University of Western Australia, Perth, WA, Australia
| | - Ralph N Martins
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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Tzelefa V, Tsirimiagkou C, Argyris A, Moschonis G, Perogiannakis G, Yannakoulia M, Sfikakis P, Protogerou AD, Karatzi K. Associations of dietary patterns with blood pressure and markers of subclinical arterial damage in adults with risk factors for cardiovascular disease. Public Health Nutr 2021;:1-25. [PMID: 34392855 DOI: 10.1017/S1368980021003499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Unhealthy diet is a modifiable risk factors leading to subclinical arterial damage (SAD), high BP and CVD. It was aimed to investigate the possible associations of dietary patterns (DPs) with SAD in adults having multiple CVD risk factors. DESIGN Dietary intake was evaluated through two 24-h dietary recalls and principal component analysis was used to identify DPs. Oscillometry, applanation tonometry with pulse wave analysis and carotid ultrasound were used to assess peripheral and aortic BP, arterial stiffness and pressure wave reflections. SETTING Laiko University Hospital, Athens, Greece. PARTICIPANTS 470 individuals (53.1±14.2 years) with CVD risk factors were enrolled. RESULTS A pattern characterized by increased consumption of whole-grain cereals, white meat and reduced consumption of sugar was positively associated with common carotid compliance (β=0.01, 95%CI 0.00 - 0.01, whereas a pattern high in refined cereals, red and processed meat was positively associated with brachial but not aortic systolic pressure (β=1.76, 95%CI 0.11 - 3.42) and mean arterial pressure (MAP) (β=1.18, 95%CI=0.02 -2.38). Low consumption of low-fat dairy products, high consumption of full fat cheese and butter was positively associated with MAP (β=0.97,95%CI=0.01 - 1.95). Increased consumption of vegetables, fruits, fresh juices, fish and seafood was inversely associated with augmentation index (AIx) (β=-1.01,95% CI=-1.93 - 0.09). CONCLUSION Consumption of whole grains, white meat, fruits/vegetables, fish/seafood, and avoidance of sugar was associated with improved SAD. Preference in refined grains, red/processed meat, high fat cheese/butter and low intake of low-fat dairy products was associated with BP elevation. Future studies are needed to confirm the present findings.
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Abstract
BACKGROUND Cardiovascular disorders are the leading cause of morbidity and mortality throughout the globe. Hypertension is the main risk factor that contributes to the development of many diseases. The use of herbal therapies, medicinal plants and their derivatives for the remedy and management of hypertension is well-recognized and popular among a wide part of the world population. METHODS The aim of the current review was to collect, treat, and critically analyze the published research studies relative to experimental and clinical investigations which have studied the blood pressure lowering abilities of medicinal plant derivatives in the last decade. This review was organized into three principal axes; the first axis was attributed to the in vivo and in vitro experimental studies; the second treated the clinical trials; while, the last one is devoted to analyze the mechanisms of action underlying the therapeutic antihypertensive effectiveness of phytochemicals. RESULTS Different types of extracts and isolated molecules obtained from a large variety of species demonstrated their efficiency in improving the increase of blood pressure either experimentally or clinically. Medicinal species such as garlic (Allium sativum), celery (Apium graveolens), Black Cumin (Nigella sativa) and Ginseng (Panax) are among the most common and therapeutically used plant derivatives for controlling hypertension while Asteraceae, Apiaceae and Rosaceae are among the botanical families which were frequently studied in the last decade. Isolated compounds such as allicin and apigenin have received more interest in this field. Recent evidence from clinical trials suggests that a wide variety of herbal preparations and plant extracts or natural isolated compounds have a favorable therapeutic impact on blood flow. Interestingly, phytochemicals can either act directly on blood vessels via a vasorelaxant effect involving a variety of signaling cascades or indirectly through inhibiting or stimulating diversity of systems such as angiotensin-converting enzyme (ACE), renin-angiotensin system (RAS) or the diuretic activity. Hence, based on the findings of the present review medicinal plant derivatives could be used as preventive and curative agents in the case of cardiovascular disorders, particularly hypertension and could play a promoting function for the discovery of new antihypertensive agents. CONCLUSION The analysis of the published data shows that a great effort remains to be done to investigate the medicinal plants cited as antihypertensive through published ethnopharmacological surveys. The analysis of the literature in this field shows the lack of standardization at the level of experimental study methods as well as the need to study purified molecules. Moreover, the mechanistic studies when they exist remain in the whole partial. On the other hand, few advanced clinical studies have been conducted. Finally, the determination of the efficacy/safety ratio remains absent in almost all studies.
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Affiliation(s)
- Mohammed Ajebli
- Department of Biology, Faculty of Sciences and Techniques Errachidia, Team of Endocrine Physiology and Pharmacology, Moulay Ismail University of Meknes, BP 509, Boutalamine 52000, Errachidia, Morocco
| | - Mohamed Eddouks
- Department of Biology, Faculty of Sciences and Techniques Errachidia, Team of Endocrine Physiology and Pharmacology, Moulay Ismail University of Meknes, BP 509, Boutalamine 52000, Errachidia, Morocco
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26
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Banerjee T, Carrero JJ, McCulloch C, Burrows NR, Siegel KR, Morgenstern H, Saran R, Powe NR. Dietary Factors and Prevention: Risk of End-Stage Kidney Disease by Fruit and Vegetable Consumption. Am J Nephrol 2021; 52:356-367. [PMID: 34044392 PMCID: PMC8263504 DOI: 10.1159/000514754] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The association between fruit and vegetable (FV) intake and the risk of end-stage kidney disease (ESKD) has not been examined in the general population and fully explored in chronic kidney disease (CKD). We prospectively evaluated this relationship in US representative sample of adults and evaluated consistency by the presence or absence, and severity, of CKD. METHODS We used data from the Third National Health and Nutrition Examination Survey (1988-1994) linked with the US Renal Data System, including 14,725 adults aged ≥20 years and with follow-up for ESKD through 2008. Daily FV intake was ascertained using a food frequency questionnaire. We examined the association between selected categories of FV intake and ESKD using a Fine Gray competing risk model adjusting for sociodemographics, lifestyle, clinical and nutritional factors, estimated glomerular filtration rate, and albuminuria. We evaluated whether risk varied in individuals with severe versus any CKD. RESULTS 230 participants (1.5%) developed ESKD during follow-up. In the adjusted model, compared to highest intake, those in lowest categories of FV intake had a higher risk of ESKD, for <2 times/day (1.45 [1.24-1.68], 2 to <3 times/day (1.40 [1.18-1.61]), 3 to <4 times/day (1.25 [1.04-1.46]), and 4 to <6 times/day (1.14 [0.97-1.31]). There was suggestion of heterogeneity (p for interaction = 0.03) with possible stronger inverse association in patients with CKD than those without CKD. After stratification, we obtained similar strong inverse association when we examined ESKD incidence across intake of FVs in participants with CKD stages 1-4 (n = 5,346) and specifically in those with CKD stages 3-4 (n = 1,084). CONCLUSIONS Low intake of FVs was associated with higher risk of ESKD in US adults with and without CKD, supporting an emerging body of literature on the potential benefits of plant-rich diets for prevention of ESKD.
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Affiliation(s)
- Tanushree Banerjee
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Juan Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Charles McCulloch
- Department of Biostatistics, University of California, San Francisco, California, USA
| | - Nilka Rios Burrows
- Division of Diabetes Translation, Centers for Disease and Control and Prevention, Atlanta, Georgia, USA
| | - Karen R Siegel
- Division of Diabetes Translation, Centers for Disease and Control and Prevention, Atlanta, Georgia, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Department of Urology, Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Rajiv Saran
- Kidney Epidemiology & Cost Center, University of Michigan, Ann Arbor, Michigan, USA
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Neil R Powe
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
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Zeng J, Deng Z, Zou Y, Liu C, Fu H, Gu Y, Chang H. Theaflavin alleviates oxidative injury and atherosclerosis progress via activating microRNA-24-mediated Nrf2/HO-1 signal. Phytother Res 2021; 35:3418-3427. [PMID: 33755271 DOI: 10.1002/ptr.7064] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/06/2021] [Accepted: 02/10/2021] [Indexed: 12/18/2022]
Abstract
Theaflavin (TF) in black tea has been shown to have significant antioxidant and anti-inflammatory capacity; however, the effects and the underlying mechanism of TF on atherosclerosis (AS) remain unclear. Herein, we investigated the effects and the potential mechanism of TF on AS progression in vivo and in vitro. ApoE-/- mice were administrated with high fat diet (HFD) or HFD + TF (5 or 10 mg, i.g.) for 12 weeks. The results indicated that TF administration effectively decreases the serum lipid levels and the production of MDA in HFD-fed mice. Meanwhile, TF promotes the activities of antioxidant enzymes (SOD, CAT, and GSH-Px) and inhibits the formation of atherosclerotic plaque and the process of histological alterations in the aorta. In vitro, TF pretreatment could protect against cholesterol-induced oxidative injuries in HUVEC cells, decreasing the level of ROS and MDA, maintaining the activities of antioxidant enzymes. Further study revealed that TF upregulates Nrf2/HO-1 signaling pathway in vascular endothelial cells. Moreover, TF increases the level of microRNA-24 (miR-24), and miR-24 inhibition markedly compromises TF-induced Nrf2 activation and protective effects. In conclusion, the present study indicated that theaflavins may achieve the anti-atherosclerotic effect via activating miR-24-mediated Nrf2/HO-1 signaling pathway.
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Affiliation(s)
- Jie Zeng
- College of Food Science, Southwest University, Chongqing, China
| | - Zhihui Deng
- College of Food Science, Southwest University, Chongqing, China
| | - Yixin Zou
- College of Food Science, Southwest University, Chongqing, China
| | - Chang Liu
- College of Food Science, Southwest University, Chongqing, China
| | - Hongjuan Fu
- College of Food Science, Southwest University, Chongqing, China
| | - Yi Gu
- College of Food Science, Southwest University, Chongqing, China
| | - Hui Chang
- College of Food Science, Southwest University, Chongqing, China
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Qi J, Li K, Shi Y, Li Y, Dong L, Liu L, Li M, Ren H, Liu X, Fang C, Luo J. Cross-Species Comparison of Metabolomics to Decipher the Metabolic Diversity in Ten Fruits. Metabolites 2021; 11:metabo11030164. [PMID: 33809004 PMCID: PMC8000971 DOI: 10.3390/metabo11030164] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Abstract
Fruits provide humans with multiple kinds of nutrients and protect humans against worldwide nutritional deficiency. Therefore, it is essential to understand the nutrient composition of various fruits in depth. In this study, we performed LC-MS-based non-targeted metabolomic analyses with ten kinds of fruit, including passion fruit, mango, starfruit, mangosteen, guava, mandarin orange, grape, apple, blueberry, and strawberry. In total, we detected over 2500 compounds and identified more than 300 nutrients. Although the ten fruits shared 909 common-detected compounds, each species accumulated a variety of species-specific metabolites. Additionally, metabolic profiling analyses revealed a constant variation in each metabolite’s content across the ten fruits. Moreover, we constructed a neighbor-joining tree using metabolomic data, which resembles the single-copy protein-based phylogenetic tree. This indicates that metabolome data could reflect the genetic relationship between different species. In conclusion, our work enriches knowledge on the metabolomics of fruits, and provides metabolic evidence for the genetic relationships among these fruits.
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Affiliation(s)
- Jinwei Qi
- School of Horticulture, Hainan University, Haikou 570288, China;
| | - Kang Li
- School of Tropical Crops, Hainan University, Haikou 570288, China; (K.L.); (Y.S.); (L.L.); (M.L.); (X.L.)
| | - Yunxia Shi
- School of Tropical Crops, Hainan University, Haikou 570288, China; (K.L.); (Y.S.); (L.L.); (M.L.); (X.L.)
| | - Yufei Li
- National Key Laboratory of Crop Genetic Improvement and National Center of Plant Gene Research (Wuhan), Huazhong Agricultural University, Wuhan 430070, China;
| | - Long Dong
- Horticultural Research Institute, Guangxi Academy of Agricultural Sciences, Nanning 530007, China; (L.D.); (H.R.)
| | - Ling Liu
- School of Tropical Crops, Hainan University, Haikou 570288, China; (K.L.); (Y.S.); (L.L.); (M.L.); (X.L.)
| | - Mingyang Li
- School of Tropical Crops, Hainan University, Haikou 570288, China; (K.L.); (Y.S.); (L.L.); (M.L.); (X.L.)
| | - Hui Ren
- Horticultural Research Institute, Guangxi Academy of Agricultural Sciences, Nanning 530007, China; (L.D.); (H.R.)
| | - Xianqing Liu
- School of Tropical Crops, Hainan University, Haikou 570288, China; (K.L.); (Y.S.); (L.L.); (M.L.); (X.L.)
| | - Chuanying Fang
- School of Tropical Crops, Hainan University, Haikou 570288, China; (K.L.); (Y.S.); (L.L.); (M.L.); (X.L.)
- Correspondence: (C.F.); (J.L.)
| | - Jie Luo
- School of Tropical Crops, Hainan University, Haikou 570288, China; (K.L.); (Y.S.); (L.L.); (M.L.); (X.L.)
- National Key Laboratory of Crop Genetic Improvement and National Center of Plant Gene Research (Wuhan), Huazhong Agricultural University, Wuhan 430070, China;
- Correspondence: (C.F.); (J.L.)
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Bolea G, Philouze C, Dubois M, Risdon S, Humberclaude A, Ginies C, Charles AL, Geny B, Reboul C, Arnaud C, Dufour C, Meyer G. Digestive n-6 Lipid Oxidation, a Key Trigger of Vascular Dysfunction and Atherosclerosis in the Western Diet: Protective Effects of Apple Polyphenols. Mol Nutr Food Res 2021; 65:e2000487. [PMID: 33450108 DOI: 10.1002/mnfr.202000487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/04/2021] [Indexed: 01/07/2023]
Abstract
SCOPE A main risk factor of atherosclerosis is a Western diet (WD) rich in n-6 polyunsaturated fatty acids (PUFAs) sensitive to oxidation. Their oxidation can be initiated by heme iron of red meat leading to the formation of 4-hydroxy-2-nonenal (4-HNE), a cytotoxic aldehyde. An increased 4-HNE production is implicated in endothelial dysfunction and atherosclerosis. By contrast, a diet rich in proanthocyanidins reduces oxidative stress and arterial diseases. This study evaluates the effects of a WD on vascular integrity in ApolipoproteinE (ApoE-/- ) mice and the protective capacity of apple extract and puree rich in antioxidant proanthocyanidins. METHODS AND RESULTS ApoE-/- mice are fed during 12 weeks with a WD with or without n-6 PUFAs. Moreover, two WD + n-6 PUFAs groups are supplemented with apple puree or phenolic extract. An increase in digestive 4-HNE production associated with a rise in plasmatic 4-HNE and oxidized LDL concentrations is reported. Oxidizable n-6 PUFAs consumption is associated with a worsened endothelial dysfunction and atherosclerosis. Interestingly, supplementations with apple polyphenol extract or puree prevented these impairments while reducing oxidative stress. CONCLUSION n-6 lipid oxidation during digestion may be a key factor of vascular impairments. Nevertheless, an antioxidant strategy can limit 4-HNE formation during digestion and thus durably protect vascular function.
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Affiliation(s)
- Gaëtan Bolea
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-ecology, Avignon University, Avignon, F-84000, France
- INRAE, UMR408 SQPOV, Safety and Quality of Plant Products, Avignon University, Avignon, F-84000, France
| | - Clothilde Philouze
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-ecology, Avignon University, Avignon, F-84000, France
| | - Mathilde Dubois
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-ecology, Avignon University, Avignon, F-84000, France
| | - Sydney Risdon
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-ecology, Avignon University, Avignon, F-84000, France
| | - Anaïs Humberclaude
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-ecology, Avignon University, Avignon, F-84000, France
| | - Christian Ginies
- INRAE, UMR408 SQPOV, Safety and Quality of Plant Products, Avignon University, Avignon, F-84000, France
| | - Anne-Laure Charles
- UR3072, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072, Mitochondria, Oxidative Stress and Muscle Protection, University of Strasbourg, Strasbourg, F-67000, France
| | - Bernard Geny
- UR3072, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072, Mitochondria, Oxidative Stress and Muscle Protection, University of Strasbourg, Strasbourg, F-67000, France
| | - Cyril Reboul
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-ecology, Avignon University, Avignon, F-84000, France
| | - Claire Arnaud
- U1042 HP2, Cardiovascular and Respiratory Pathophysiology and Hypoxia, INSERM, Grenoble University, Grenoble, F-38000, France
| | - Claire Dufour
- INRAE, UMR408 SQPOV, Safety and Quality of Plant Products, Avignon University, Avignon, F-84000, France
| | - Grégory Meyer
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-ecology, Avignon University, Avignon, F-84000, France
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Abstract
Fruits are considered healthy because of their high antioxidant, vitamin, mineral, fiber, and phytochemical contents. However, their high sugar content is a concern for glucose, lipid, and uric acid metabolism. We reviewed related articles published in the last 10 years and summarized evidence that relates fruit intake to the prevention and control of hypertension and diabetes mellitus. Clinicians should familiarize themselves with appropriate fruit intake to counsel at-risk patients on hypertension and diabetes.
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Affiliation(s)
- Hyun Ah Park
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Wang W, Wang Y, Gao X, Zhao Z, Li L, Yu B, Liu G, Lin P. Association between food and nutrients intakes and coronary plaque vulnerability in patients with coronary heart disease: An optical coherence tomography study. Nutr Metab Cardiovasc Dis 2021; 31:201-208. [PMID: 33268215 DOI: 10.1016/j.numecd.2020.08.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/26/2020] [Accepted: 08/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Dietary intakes play important roles in the prevention and treatment of coronary heart disease (CHD). Coronary plaque vulnerability is the key mechanism leading to CHD progression. We aimed to explore the association between dietary intakes and plaque vulnerability via optical coherence tomography (OCT). METHODS AND RESULTS A total of 314 CHD patients were included in this study. Dietary intake status was assessed by semi-quantitative food frequency questionnaire and plaque vulnerability was measured by OCT. The results showed that vegetables were negatively associated with macrophage infiltration, thin cap fibroatheroma (TCFA) and thrombus [odds ratio (OR) = 0.48, 0.38, 0.38, 95% confidence interval (95% CI) = 0.24-0.93, 0.17-0.84, 0.15-0.94, all P < 0.05]; fruits were negatively associated with lipid plaque, TCFA, rupture and thrombus (OR = 0.17, 0.11, 0.12, 0.20, 95% CI = 0.07-0.39, 0.04-0.29, 0.05-0.28, 0.08-0.55, all P < 0.05); salt was positively associated with lipid plaque and TCFA (OR = 2.59, 2.83, 95% CI = 1.14-5.90, 1.23-6.51, all P < 0.05). Regarding nutrients intakes, dietary fiber was negatively associated with macrophage infiltration (OR = 0.34, 95% CI = 0.14-0.85, P = 0.021); folate was negatively associated with lipid plaque, TCFA and rupture (OR = 0.22, 0.16, 0.20, 95% CI = 0.09-0.58, 0.06-0.41, 0.08-0.51, all P < 0.05); vitamin C was negatively associated with TCFA, rupture and thrombus (OR = 0.26, 0.22, 0.05, 95% CI = 0.07-0.95, 0.07-0.65, 0.01-0.25, all P < 0.05); sodium was positively associated with lipid plaque, TCFA, rupture and thrombus (OR = 3.43, 3.96, 2.73, 4.84, 95% CI = 1.51-7.80, 1.66-9.45, 1.18-6.27, 1.76-9.28, all P < 0.05). CONCLUSION Salt and sodium were dietary risk factors for plaque vulnerability, whereas vegetables, fruits, dietary fiber, folate and vitamin C were dietary protective factors for plaque vulnerability.
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Affiliation(s)
- Weiqi Wang
- College of Nursing, Harbin Medical University, Harbin, 150086, China.
| | - Yini Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Xueqin Gao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Zhenjuan Zhao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Ling Li
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Guojie Liu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China; Key Laboratory of Myocardial Ischemia, Harbin Medical University, Harbin, 150086, China.
| | - Ping Lin
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
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Kojima G, Iliffe S, Jivraj S, Walters K. Fruit and Vegetable Consumption and Incident Prefrailty and Frailty in Community-Dwelling Older People: The English Longitudinal Study of Ageing. Nutrients 2020; 12:E3882. [PMID: 33353147 DOI: 10.3390/nu12123882] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 02/06/2023] Open
Abstract
Background: There is limited evidence in the literature regarding associations between fruit and vegetable consumption and risk of frailty. Objective: To examine associations between fruit and vegetable consumption and risk of incident frailty and incident prefrailty/frailty. Design: A prospective panel study. Setting and Subjects: 2634 non-frail community-dwelling men and women aged 60 years or older from the English Longitudinal Study of Ageing (ELSA). Methods: Fruit and vegetable consumption/day was measured using a self-completion questionnaire at baseline. Frailty status was measured at baseline and follow-up was based on modified frailty phenotype criteria. Four-year incident frailty was examined among 2634 robust or prefrail participants, and incident prefrailty/frailty was measured among 1577 robust participants. Results: Multivariable logistic regression models adjusted for age, gender, and other confounders showed that fruit and vegetable consumption was not associated with incident frailty risks among robust or prefrail participants. However, robust participants consuming 5–7.5 portions of 80 g per day (odds ratio (OR) = 0.56, 95% confidence interval (CI) = 0.37–0.85, p < 0.01) and 7.5–10 portions per day (OR = 0.46, 95%CI = 0.27–0.77, p < 0.01) had significantly lower risk of incident prefrailty/frailty compared with those consuming 0–2.5 portions/day, whereas those consuming 10 or more portions/day did not (OR = 1.10, 95%CI = 0.54–2.26, p = 0.79). Analysis repeated with fruit and vegetable separately showed overall similar results. Conclusions: Robust older adults without frailty who eat current U.K. government recommendations for fruit and vegetable consumption (5–10 portions/day) had significantly reduced risks of incident prefrailty/frailty compared with those who only eat small amount (0–2.5 portions/day). Older people can be advised that eating sufficient amounts of fruit and vegetable may be beneficial for frailty prevention.
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Ma J, Zheng Y, Tang W, Yan W, Nie H, Fang J, Liu G. Dietary polyphenols in lipid metabolism: A role of gut microbiome. Anim Nutr 2020; 6:404-409. [PMID: 33364456 PMCID: PMC7750795 DOI: 10.1016/j.aninu.2020.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 12/19/2022]
Abstract
Polyphenols are a class of non-essential phytonutrients, which are abundant in fruits and vegetables. Dietary polyphenols or foods rich in polyphenols are widely recommended for metabolic health. Indeed, polyphenols (i.e., catechins, resveratrol, and curcumin) are increasingly recognized as a regulator of lipid metabolism in host. The mechanisms, at least in part, may be highly associated with gut microbiome. This review mainly discussed the beneficial effects of dietary polyphenols on lipid metabolism. The potential mechanisms of gut microbiome are focused on the effect of dietary polyphenols on gut microbiota compositions and how gut microbiota affect polyphenol metabolism. Together, dietary polyphenols may be a useful nutritional strategy for manipulation of lipid metabolism or obesity care.
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Affiliation(s)
- Jie Ma
- College of Bioscience and Biotechnology, College of Animal Science and Technology, Hunan Agricultural University, Hunan Provincial Engineering Research Center of Applied Microbial Resources Development for Livestock and Poultry, Changsha, Hunan, China
| | - Yongmin Zheng
- College of Bioscience and Biotechnology, College of Animal Science and Technology, Hunan Agricultural University, Hunan Provincial Engineering Research Center of Applied Microbial Resources Development for Livestock and Poultry, Changsha, Hunan, China
| | - Wenjie Tang
- College of Bioscience and Biotechnology, College of Animal Science and Technology, Hunan Agricultural University, Hunan Provincial Engineering Research Center of Applied Microbial Resources Development for Livestock and Poultry, Changsha, Hunan, China
- Key Laboratory of Agro-Ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Chinese Academy of Sciences, Changsha, Hunan, China
- Sichuan Academy of Animal Sciences, Animal Breeding and Genetics Key Laboratory of Sichuan Province, Chengdu, China
| | - Wenxin Yan
- College of Bioscience and Biotechnology, College of Animal Science and Technology, Hunan Agricultural University, Hunan Provincial Engineering Research Center of Applied Microbial Resources Development for Livestock and Poultry, Changsha, Hunan, China
| | - Houfu Nie
- Agricultural and Rural Office of Chunkou Town, Liuyang, Hunan, China
| | - Jun Fang
- College of Bioscience and Biotechnology, College of Animal Science and Technology, Hunan Agricultural University, Hunan Provincial Engineering Research Center of Applied Microbial Resources Development for Livestock and Poultry, Changsha, Hunan, China
| | - Gang Liu
- College of Bioscience and Biotechnology, College of Animal Science and Technology, Hunan Agricultural University, Hunan Provincial Engineering Research Center of Applied Microbial Resources Development for Livestock and Poultry, Changsha, Hunan, China
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Di Pietro N, Baldassarre MPA, Cichelli A, Pandolfi A, Formoso G, Pipino C. Role of Polyphenols and Carotenoids in Endothelial Dysfunction: An Overview from Classic to Innovative Biomarkers. Oxid Med Cell Longev 2020; 2020:6381380. [PMID: 33133348 PMCID: PMC7593735 DOI: 10.1155/2020/6381380] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/26/2020] [Accepted: 10/05/2020] [Indexed: 12/14/2022]
Abstract
Nowadays, the dramatically increased prevalence of metabolic diseases, such as obesity and diabetes mellitus and their related complications, including endothelial dysfunction and cardiovascular disease, represents one of the leading causes of death worldwide. Dietary nutrients together with healthy lifestyles have a crucial role in the endothelium health-promoting effects. From a growing body of evidence, active natural compounds from food, including polyphenols and carotenoids, have attracted particular attention as a complementary therapy on atherosclerosis and cardiovascular disease, as well as preventive approaches through the attenuation of inflammation and oxidative stress. They mainly act as radical scavengers by promoting a variety of biological mechanisms, such as improvements in endothelial function, blood pressure, platelet activity, and insulin sensitivity, and by modulating various known biomarkers. The present review highlights the role of polyphenols and carotenoids in early endothelial dysfunction with attention to their beneficial effect in modulating both classical and recent technologically generated emerging biomarkers. These, alone or in combination, can play an important role in the prediction, diagnosis, and evolution of cardiovascular disease. However, a main challenge is to speed up early and prompt new interventions in order to prevent or slow down disease progression, even with an adequate intake of bioactive compounds. Hence, there is an urgent need of new more validated, appropriate, and reliable diagnostic and therapeutic biomarkers useful to diagnose endothelial dysfunction at an earlier stage.
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Affiliation(s)
- Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Maria Pompea Antonia Baldassarre
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Angelo Cichelli
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Assunta Pandolfi
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Gloria Formoso
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Caterina Pipino
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
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Sharma D, Nanjundan J, Singh L, Singh SP, Parmar N, Sujith Kumar MS, Singh KH, Mishra AK, Singh R, Verma KS, Thakur AK. Genetic diversity in leafy mustard ( Brassica juncea var. rugosa) as revealed by agro-morphological traits and SSR markers. Physiol Mol Biol Plants 2020; 26:2005-2018. [PMID: 33088045 PMCID: PMC7548306 DOI: 10.1007/s12298-020-00883-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/18/2020] [Accepted: 09/07/2020] [Indexed: 05/27/2023]
Abstract
Leafy mustard (B. juncea var. rugosa) constitutes an important group of vegetable mustard crops in India and is mainly cultivated in home-backyard and hilly regions of Uttarakhand and some North-eastern states. In the present study, various agro-morphological traits, physiological and biochemical traits along with SSR markers were used for genetic diversity evaluation in a germplasm collection of leafy mustard. This study revealed a significant variation among 59 accessions of leafy mustard in both qualitative and quantitative agro-morphological traits indicating the accessions' promising potential for consumption purpose and for use in breeding programs. Maximum variability was recorded for leaf area elongation rate (CV = 53.12%), followed by total plant weight (TPW) (CV = 50.63%) and seed yield per plant (CV = 44.33%). In molecular analysis, 155 SSRs evaluated resulted in 482 alleles and the number of alleles varied form 1 to 8 with an average of 3.11 alleles per marker. A total of 122 (78.70%) SSRs resulted into polymorphic amplicons. PIC value varied from 0.32 to 0.77 with an average value of 0.44 per SSR locus. The unweighted neighbour-joining-based dendrogram analysis divided all the 59 accessions into two major groups on the basis of both agro-morphological traits and SSR markers, whereas, three subpopulations/subgroups were predicted by population STRUCTURE analysis. AMOVA indicated the presence of more variability within population than among population. Overall, agro-morphologically better performing and genetically diverse genotypes have been identified which could be further used as donors for leafy mustard improvement programs.
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Affiliation(s)
- Deepika Sharma
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 302 006 India
| | - J. Nanjundan
- ICAR-Indian Agricultural Research Institute-Regional Station, Wellington, Tamilnadu 643 231 India
| | - Lal Singh
- ICAR-Directorate of Rapeseed-Mustard Research, Bharatpur, Rajasthan 321 303 India
| | - S. P. Singh
- ICAR-Directorate of Rapeseed-Mustard Research, Bharatpur, Rajasthan 321 303 India
| | - Nehanjali Parmar
- ICAR-Directorate of Rapeseed-Mustard Research, Bharatpur, Rajasthan 321 303 India
| | - M. S. Sujith Kumar
- ICAR-Directorate of Rapeseed-Mustard Research, Bharatpur, Rajasthan 321 303 India
| | - K. H. Singh
- ICAR-Directorate of Rapeseed-Mustard Research, Bharatpur, Rajasthan 321 303 India
| | - A. K. Mishra
- ICAR-National Bureau of Plant Genetic Resources Regional Station, Shillong, Meghalaya 793 103 India
| | - Ranbir Singh
- ICAR-National Bureau of Plant Genetic Resources, New Delhi, 110 012 India
| | - Kumar Sambhav Verma
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 302 006 India
| | - Ajay Kumar Thakur
- ICAR-Directorate of Rapeseed-Mustard Research, Bharatpur, Rajasthan 321 303 India
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Arabzadegan N, Daneshzad E, Fatahi S, Moosavian SP, Surkan PJ, Azadbakht L. Effects of dietary whole grain, fruit, and vegetables on weight and inflammatory biomarkers in overweight and obese women. Eat Weight Disord 2020; 25:1243-1251. [PMID: 31399910 DOI: 10.1007/s40519-019-00757-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/19/2019] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The separate effects of whole grain (WG) and fruit and vegetable (F&V) diets on inflammatory biomarkers have not been assessed. Therefore, we evaluated these two high-fiber diets in relation to inflammation indices in obese and overweight women. STUDY DESIGN Parallel randomized clinical trial. METHODS In the present study, 75 women were recruited and randomly assigned to three diet groups: a whole grain diet (WG-D) group, F&V group, and a combined whole grain and F&V diet group (WGFV-D) for 10 weeks. As a "feeding trial" all participants were asked to visit the clinic daily and eat prescribed foods in the presence of a nutritionist. Anthropometric indices and biochemical biomarkers were measured at baseline and after 10 weeks of the trial. RESULTS Each of the three diet groups showed significant changes in serum biomarkers (CRP, TNF-α, IL-6, D-dimer, and serum fibrinogen) after following the diet for 10 weeks (P = 0.01). In adjusted models, significant changes were observed for CRP, TNF-α, IL-6, D-dimer, and serum fibrinogen (P = 0.01). In a model adjusted for malondialdehyde (MDA) level, a trend toward significance was observed (P = 0.05). Consumption of all three different diets for 10 weeks showed statistically significant change for all biomarkers (P < 0.05) the most notable changes in inflammatory indices were observed among participants following the WG diet. CONCLUSIONS Study results indicate that consumption of high-fiber diets, especially the WG diet, can help lower inflammatory levels and prevent subsequent adverse health consequences. LEVEL OF EVIDENCE Level I, randomized controlled trial.
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Affiliation(s)
- Niloufar Arabzadegan
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Daneshzad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Fatahi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Parisa Moosavian
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Yamagata K, Hashiguchi K, Yamamoto H, Tagami M. Dietary Apigenin Reduces Induction of LOX-1 and NLRP3 Expression, Leukocyte Adhesion, and Acetylated Low-Density Lipoprotein Uptake in Human Endothelial Cells Exposed to Trimethylamine-N-Oxide. J Cardiovasc Pharmacol 2019; 74:558-65. [PMID: 31815868 DOI: 10.1097/FJC.0000000000000747] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
By inducing vascular inflammation, trimethylamine-N-oxide (TMAO) is associated with endothelial dysfunction, atherosclerosis, and enhanced risk of cardiovascular diseases in humans. However, the underlying mechanisms are unknown. Expression of several genes related to arteriosclerosis, inflammasomes, and endothelial dysfunction was quantified by polymerase chain reaction after exposure to TMAO. LOX-1, ICAM-1, and NLRP3 were also quantified by Western blot, whereas leukocytic adhesion was examined using fluorescently labeled U937 cells. Scavenger receptors, adhesion molecules, and other genes associated with atherosclerosis were induced in endothelial cells exposed to TMAO. On the other hand, apigenin, a flavonoid that is abundant in parsley and celery, prevents initial arteriosclerosis events in endothelial cells. Apigenin reversed the effects of TMAO on mRNA expression of LOX-1, SREC, SR-PSOX, NLRP3, ASC, TXNIP, VCAM-1, ICAM-1, and MCP-1, as well as protein expression of LOX-1, the adhesion molecule ICAM-1, and the inflammasome protein NLRP3. Apigenin also suppressed leukocyte adhesion and uptake of acetylated low-density lipoprotein. The data indicate that expression of scavenger receptors and adhesion molecules in response to TMAO, along with formation of NLRP3 inflammasomes, may drive endothelial dysfunction through uptake of acetylated low-density lipoprotein and lymphocyte adhesion. Apigenin reverses these effects, implying that it may also prevent arteriosclerosis.
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Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, La Frano MR, Bohn T. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12. [PMID: 32471251 PMCID: PMC7352291 DOI: 10.3390/nu12061562] [Citation(s) in RCA: 383] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022] Open
Abstract
The coronavirus-disease 2019 (COVID-19) was announced as a global pandemic by the World Health Organization. Challenges arise concerning how to optimally support the immune system in the general population, especially under self-confinement. An optimal immune response depends on an adequate diet and nutrition in order to keep infection at bay. For example, sufficient protein intake is crucial for optimal antibody production. Low micronutrient status, such as of vitamin A or zinc, has been associated with increased infection risk. Frequently, poor nutrient status is associated with inflammation and oxidative stress, which in turn can impact the immune system. Dietary constituents with especially high anti-inflammatory and antioxidant capacity include vitamin C, vitamin E, and phytochemicals such as carotenoids and polyphenols. Several of these can interact with transcription factors such as NF-kB and Nrf-2, related to anti-inflammatory and antioxidant effects, respectively. Vitamin D in particular may perturb viral cellular infection via interacting with cell entry receptors (angiotensin converting enzyme 2), ACE2. Dietary fiber, fermented by the gut microbiota into short-chain fatty acids, has also been shown to produce anti-inflammatory effects. In this review, we highlight the importance of an optimal status of relevant nutrients to effectively reduce inflammation and oxidative stress, thereby strengthening the immune system during the COVID-19 crisis.
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Moorthy M, Chaiyakunapruk N, Jacob SA, Palanisamy UD. Prebiotic potential of polyphenols, its effect on gut microbiota and anthropometric/clinical markers: A systematic review of randomised controlled trials. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.03.036] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
BACKGROUND Previous studies have shown that intake of polyphenols through the consumption of vegetables and fruits reduces the risk of Cardiovascular Disease (CVD) by potentially influencing endothelial cell function. OBJECTIVE In this review, the effects and molecular mechanisms of plant polyphenols, particularly resveratrol, epigallocatechin gallate (EGCG), and quercetin, on endothelial functions, and their putative protective effects against CVD are described. METHODS Epidemiologic studies examined the effect of the CVD risk of vegetables and the fruit. Furthermore, studies within vitro models investigated the underlying molecular mechanisms of the action of the flavonoid class of polyphenols. These findings help elucidate the effect of polyphenols on endothelial function and CVD risk reduction. RESULTS Epidemiologic and in vitro studies have demonstrated that the consumption of vegetables and fruits decreases the incidence of CVDs. Furthermore, it has also been indicated that dietary polyphenols are inversely related to the risk of CVD. Resveratrol, EGCG, and quercetin prevent oxidative stress by regulating the expression of oxidase and the antioxidant enzyme genes, contributing to the prevention of stroke, hypertension, heart failure, and ischemic heart disease. CONCLUSION High intake of dietary polyphenols may help prevent CVD. Polyphenols inhibit endothelial dysfunction and induce vascular endothelium-dependent vascular relaxation viz. redox regulation and nitric oxide production. The polyphenol-induced healthy endothelial cell function may be related to CVD prevention.
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Affiliation(s)
- Kazuo Yamagata
- Laboratory of Molecular Health Science of Food, Department of Food Science & Technology, Nihon University (NUBS), 1866 Kameino, Fujisawa, Kanagawa, 252-8510, Japan
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Butler T, Kerley CP, Altieri N, Alvarez J, Green J, Hinchliffe J, Stanford D, Paterson K. Optimum nutritional strategies for cardiovascular disease prevention and rehabilitation (BACPR). Heart 2020; 106:724-731. [PMID: 32098809 PMCID: PMC7229899 DOI: 10.1136/heartjnl-2019-315499] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/28/2019] [Accepted: 01/02/2020] [Indexed: 12/20/2022] Open
Abstract
Nutrition has a central role in both primary and secondary prevention of cardiovascular disease yet only relatively recently has food been regarded as a treatment, rather than as an adjunct to established medical and pharmacotherapy. As a field of research, nutrition science is constantly evolving making it difficult for patients and practitioners to ascertain best practice. This is compounded further by the inherent difficulties in performing double-blind randomised controlled trials. This paper covers dietary patterns that are associated with improved cardiovascular outcomes, including the Mediterranean Diet but also low-carbohydrate diets and the potential issues encountered with their implementation. We suggest there must be a refocus away from macronutrients and consideration of whole foods when advising individuals. This approach is fundamental to practice, as clinical guidelines have focused on macronutrients without necessarily considering their source, and ultimately people consume foods containing multiple nutrients. The inclusion of food-based recommendations aids the practitioner to help the patient make genuine and meaningful changes in their diet. We advocate that the cardioprotective diet constructed around the traditional Mediterranean eating pattern (based around vegetables and fruits, nuts, legumes, and unrefined cereals, with modest amounts of fish and shellfish, and fermented dairy products) is still important. However, there are other approaches that can be tried, including low-carbohydrate diets. We encourage practitioners to adopt a flexible dietary approach, being mindful of patient preferences and other comorbidities that may necessitate deviations away from established advice, and advocate for more dietitians in this field to guide the multi-professional team.
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Affiliation(s)
- Tom Butler
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK .,BACPR Diet Working Group
| | - Conor P Kerley
- BACPR Diet Working Group.,Connolly Hospital Blanchardstown, Dublin, Ireland
| | - Nunzia Altieri
- BACPR Diet Working Group.,Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Joe Alvarez
- BACPR Diet Working Group.,Whittington Health NHS Trust, London, UK
| | - Jane Green
- BACPR Diet Working Group.,Doddington Hospital - Cambridgeshire and Peterborough NHS Foundation Trust, Doddington, UK
| | - Julie Hinchliffe
- BACPR Diet Working Group.,Salford Royal NHS Foundation Trust, Salford, UK
| | - Dell Stanford
- BACPR Diet Working Group.,Department of Community Cardiology, Central London Community NHS Trust, Berkhamstead, UK
| | - Katherine Paterson
- BACPR Diet Working Group.,Norfolk and Norwich University Hospital, Norwich, UK
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Koutsos A, Riccadonna S, Ulaszewska MM, Franceschi P, Trošt K, Galvin A, Braune T, Fava F, Perenzoni D, Mattivi F, Tuohy KM, Lovegrove JA. Two apples a day lower serum cholesterol and improve cardiometabolic biomarkers in mildly hypercholesterolemic adults: a randomized, controlled, crossover trial. Am J Clin Nutr 2020; 111:307-318. [PMID: 31840162 PMCID: PMC6997084 DOI: 10.1093/ajcn/nqz282] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/21/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Apples are rich in bioactive polyphenols and fiber. Evidence suggests that consumption of apples or their bioactive components is associated with beneficial effects on lipid metabolism and other markers of cardiovascular disease (CVD). However, adequately powered randomized controlled trials are necessary to confirm these data and explore the mechanisms. OBJECTIVE We aimed to determine the effects of apple consumption on circulating lipids, vascular function, and other CVD risk markers. METHODS The trial was a randomized, controlled, crossover, intervention study. Healthy mildly hypercholesterolemic volunteers (23 women, 17 men), with a mean ± SD BMI 25.3 ± 3.7 kg/m2 and age 51 ± 11 y, consumed 2 apples/d [Renetta Canada, rich in proanthocyanidins (PAs)] or a sugar- and energy-matched apple control beverage (CB) for 8 wk each, separated by a 4-wk washout period. Fasted blood was collected before and after each treatment. Serum lipids, glucose, insulin, bile acids, and endothelial and inflammation biomarkers were measured, in addition to microvascular reactivity, using laser Doppler imaging with iontophoresis, and arterial stiffness, using pulse wave analysis. RESULTS Whole apple (WA) consumption decreased serum total (WA: 5.89 mmol/L; CB: 6.11 mmol/L; P = 0.006) and LDL cholesterol (WA: 3.72 mmol/L; CB: 3.86 mmol/L; P = 0.031), triacylglycerol (WA: 1.17 mmol/L; CB: 1.30 mmol/L; P = 0.021), and intercellular cell adhesion molecule-1 (WA: 153.9 ng/mL; CB: 159.4 ng/mL; P = 0.028), and increased serum uric acid (WA: 341.4 μmol/L; CB: 330 μmol/L; P = 0.020) compared with the CB. The response to endothelium-dependent microvascular vasodilation was greater after the apples [WA: 853 perfusion units (PU), CB: 760 PU; P = 0.037] than after the CB. Apples had no effect on blood pressure or other CVD markers. CONCLUSIONS These data support beneficial hypocholesterolemic and vascular effects of the daily consumption of PA-rich apples by mildly hypercholesterolemic individuals.This trial was registered at clinicaltrials.gov as NCT01988389.
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Affiliation(s)
- Athanasios Koutsos
- Hugh Sinclair Unit of Human Nutrition and the Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Samantha Riccadonna
- Unit of Computational Biology, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Maria M Ulaszewska
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Pietro Franceschi
- Unit of Computational Biology, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Kajetan Trošt
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - Amanda Galvin
- Hugh Sinclair Unit of Human Nutrition and the Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Tanya Braune
- Hugh Sinclair Unit of Human Nutrition and the Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Francesca Fava
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Daniele Perenzoni
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Fulvio Mattivi
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
- Department of Physics, University of Trento, Povo, Italy
| | - Kieran M Tuohy
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and the Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
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43
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Gerage AM, Benedetti TRB, Cavalcante BR, Farah BQ, Ritti-Dias RM. Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial. Einstein (Sao Paulo) 2020; 18:eAO5227. [PMID: 32022106 PMCID: PMC6986881 DOI: 10.31744/einstein_journal/2020ao5227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023] Open
Abstract
Objective To investigate the efficacy of a behavior change program named Vida Ativa Melhorando a Saúde on cardiovascular parameters in hypertensive patients. Methods Ninety hypertensive patients aged over 40 years were randomly allocated to one of two groups: Vida Ativa Melhorando a Saúde or Control (n=45 respectively). Patients in the Vida Ativa Melhorando a Saúde group took part in a behavior change program aimed to encourage changes in physical activity levels and eating habits, according to the Social Cognitive Theory. The program consisted of 90-minute weekly group meetings conducted by a physical therapist and a dietitian. One chapter of the educational material (workbook) provided was discussed per meeting. Participants in the Control Group attended a single educative lecture on lifestyle changes. Brachial and central blood pressure, arterial stiffness and endothelial function parameters were measured pre- and post-intervention. Results Vida Ativa Melhorando a Saúde led to reduction of brachial (131.3±15.8mmHg to 125.1±17.3mmHg; p<0.01) and central (123.6±16.3mmHg to 119.0±20.6mmHg; p=0.02) systolic and brachial diastolic (123.6±16.3mmHg to 119.0±20.6mmHg; p<0.01) blood pressure values, and improvement of post-occlusive reactive hyperemia (from 5.7±2.5mL·100mL−1 to 6.5±2.1mL·100mL−1 tissue·min−1; p=0.04). No changes in body composition, heart rate and arterial stiffness parameters were detected in both groups (p>0.05). Conclusion Vida Ativa Melhorando a Saúde program improved blood pressure and microvascular reactivity in hypertensive patients. Trial registration: ClinicalTrials.gov: NCT02257268
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44
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Boléa G, Ginies C, Vallier MJ, Dufour C. Lipid protection by polyphenol-rich apple matrices is modulated by pH and pepsin in in vitro gastric digestion. Food Funct 2020; 10:3942-3954. [PMID: 31199415 DOI: 10.1039/c9fo00705a] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Lipid oxidation takes place in the gastric tract after the ingestion of a Western diet rich in ω-6 polyunsaturated fatty acids (PUFA) and red meat (heme iron). The incorporation of oxidation products such as 4-hydroxy-2-nonenal (4-HNE) into low-density lipoproteins is further correlated to endothelial dysfunction. Gastric postprandial stress could thus be reduced by antioxidant phytomicronutrients. The aim of this study was to investigate dietary lipid oxidation and its inhibition by apple polyphenols under different matrix forms (fresh fruit, puree, extract) under in vitro gastric digestion conditions. A deep insight was given into the two factors pH and pepsin governing the metmyoglobin-initiated lipid oxidation of sunflower oil-in-water emulsions simulating the physical state of dietary lipids. Our results first showed that pepsin accelerated lipid oxidation at pH 5 through the formation of a micro-metmyoglobin form likely displaying a higher accessibility to lipids. Spectroscopic studies further highlighted the formation of a reversible unfolded metmyoglobin form at pH 3 which was shown to be more pro-oxidant in the absence of pepsin. At nutritional levels, the three apple matrices inhibited less efficiently the accumulation of lipid-derived conjugated dienes and 4-HNE at pH 5 when pepsin was present whereas at pH 3 the opposite was true. High initial bioaccessibilities of monomeric phenolic compounds were evidenced for both puree (57-74%) and the phenolic extract (79-96%) compared to fresh apple (1-14%) supporting their greater antioxidant capacity. By contrast, the bioaccessibility of dimer B2 was low for all matrices suggesting non-covalent binding to apple pectins.
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Affiliation(s)
- Gaëtan Boléa
- UMR408 SQPOV "Safety and Quality of Plant Products", INRA, University of Avignon, F-84000 Avignon, France. and EA4278 LaPEC "Laboratory of Cardiovascular Pharm-ecology", University of Avignon, F-84000 Avignon, France
| | - Christian Ginies
- UMR408 SQPOV "Safety and Quality of Plant Products", INRA, University of Avignon, F-84000 Avignon, France.
| | - Marie-José Vallier
- UMR408 SQPOV "Safety and Quality of Plant Products", INRA, University of Avignon, F-84000 Avignon, France.
| | - Claire Dufour
- UMR408 SQPOV "Safety and Quality of Plant Products", INRA, University of Avignon, F-84000 Avignon, France.
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45
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Tabatabaei-Malazy O, Abdollahi M, Larijani B. Beneficial Effects of Anti-Oxidative Herbal Medicines in Diabetic Patients Infected with COVID-19: A Hypothesis. Diabetes Metab Syndr Obes 2020; 13:3113-3116. [PMID: 32943897 PMCID: PMC7467661 DOI: 10.2147/dmso.s264824] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/07/2020] [Indexed: 01/08/2023] Open
Abstract
During the pandemic of Coronavirus Disease 2019 (COVID-19), it is critical to introduce potential medical treatments. Anti-oxidative herbal medicines with evidence-based beneficial impacts in the treatment of diabetes mellitus can be suggested as an adjuvant therapy to its conventional treatments in patients infected with COVID-19.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Correspondence: Bagher Larijani Tehran University of Medical Sciences, No. 10, Next to Dr. Shariati Hospital, Jalal Al Ahmad Hwy., North Kargar Ave., Tehran1411713119, Iran Tel/Fax +982188631296-7 Email
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46
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Aune D. Plant Foods, Antioxidant Biomarkers, and the Risk of Cardiovascular Disease, Cancer, and Mortality: A Review of the Evidence. Adv Nutr 2019; 10:S404-S421. [PMID: 31728499 PMCID: PMC6855972 DOI: 10.1093/advances/nmz042] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 03/15/2019] [Accepted: 03/28/2019] [Indexed: 12/14/2022] Open
Abstract
Although a high intake of plant foods such as fruits, vegetables, whole grains, nuts, and legumes has been recommended for chronic disease prevention, it has been unclear what is the optimal amount of intake of these foods and whether specific subtypes are particularly beneficial. The evidence from several recently published meta-analyses on plant foods and antioxidants and various health outcomes is reviewed as well as more recently published studies. In meta-analyses of prospective studies, inverse associations were observed between intake of fruits, vegetables, whole grains, and nuts and the risk of coronary artery disease, stroke, cardiovascular disease overall, total cancer, and all-cause mortality. The strongest reductions in risk were observed at an intake of 800 g/d for fruits and vegetables, 225 g/d for whole grains, and 15-20 g/d for nuts, respectively. Whole-grain and nut consumption was also inversely associated with mortality from respiratory disease, infections, and diabetes. Stronger and more linear inverse associations were observed between blood concentrations of antioxidants (vitamin C, carotenoids, vitamin E) and cardiovascular disease, cancer, and all-cause mortality than for dietary intake. Most studies that have since been published have been consistent with these results; however, further studies are needed on subtypes of plant foods and less common causes of death. These results strongly support dietary recommendations to increase intake of plant foods, and suggest optimal intakes for chronic disease prevention may be ∼800 g/d for intakes of fruits and vegetables, 225 g/d for whole grains, and 15-20 g/d for nuts. Diets high in plant foods could potentially prevent several million premature deaths each year if adopted globally.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
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47
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Wallace TC, Bailey RL, Blumberg JB, Burton-Freeman B, Chen CYO, Crowe-White KM, Drewnowski A, Hooshmand S, Johnson E, Lewis R, Murray R, Shapses SA, Wang DD. Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake. Crit Rev Food Sci Nutr 2019; 60:2174-2211. [DOI: 10.1080/10408398.2019.1632258] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Taylor C. Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, Virginia, USA
- Think Healthy Group, Inc., Washington, DC, USA
| | - Regan L. Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Jeffrey B. Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Britt Burton-Freeman
- Center for Nutrition Research, Institute for Food Safety and Health, Illinois Institute of Technology, Bedford Park, Illinois, USA
| | - C-y. Oliver Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
- Biofortis Research, Merieux NutriSciences, Addison, Illinois, USA
| | | | - Adam Drewnowski
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Shirin Hooshmand
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Elizabeth Johnson
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Richard Lewis
- Bone and Body Composition Laboratory, College of Family and Consumer Sciences, University of Georgia, Athens, Georgia, USA
| | - Robert Murray
- College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Sue A. Shapses
- Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey, USA
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Vona R, Gambardella L, Cittadini C, Straface E, Pietraforte D. Biomarkers of Oxidative Stress in Metabolic Syndrome and Associated Diseases. Oxid Med Cell Longev. 2019;2019:8267234. [PMID: 31191805 PMCID: PMC6525823 DOI: 10.1155/2019/8267234] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/08/2019] [Accepted: 03/19/2019] [Indexed: 12/11/2022]
Abstract
Metabolic syndrome (MS) represents worldwide public health issue characterized by a set of cardiovascular risk factors including obesity, diabetes, dyslipidemia, hypertension, and impaired glucose tolerance. The link between the MS and the associated diseases is represented by oxidative stress (OS) and by the intracellular redox imbalance, both caused by the persistence of chronic inflammatory conditions that characterize MS. The increase in oxidizing species formation in MS has been accepted as a major underlying mechanism for mitochondrial dysfunction, accumulation of protein and lipid oxidation products, and impairment of the antioxidant systems. These oxidative modifications are recognized as relevant OS biomarkers potentially able to (i) clarify the role of reactive oxygen and nitrogen species in the etiology of the MS, (ii) contribute to the diagnosis/evaluation of the disease's severity, and (iii) evaluate the utility of possible therapeutic strategies based on natural antioxidants. The antioxidant therapies indeed could be able to (i) counteract systemic as well as mitochondrial-derived OS, (ii) enhance the endogenous antioxidant defenses, (iii) alleviate MS symptoms, and (iv) prevent the complications linked to MS-derived cardiovascular diseases. The focus of this review is to summarize the current knowledge about the role of OS in the development of metabolic alterations characterizing MS, with particular regard to the occurrence of OS-correlated biomarkers, as well as to the use of therapeutic strategies based on natural antioxidants.
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De Bruyne T, Steenput B, Roth L, De Meyer GRY, Santos CND, Valentová K, Dambrova M, Hermans N. Dietary Polyphenols Targeting Arterial Stiffness: Interplay of Contributing Mechanisms and Gut Microbiome-Related Metabolism. Nutrients 2019; 11:E578. [PMID: 30857217 PMCID: PMC6471395 DOI: 10.3390/nu11030578] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/15/2022] Open
Abstract
Increased arterial stiffness is a degenerative vascular process, progressing with age that leads to a reduced capability of arteries to expand and contract in response to pressure changes. This progressive degeneration mainly affects the extracellular matrix of elastic arteries and causes loss of vascular elasticity. Recent studies point to significant interference of dietary polyphenols with mechanisms involved in the pathophysiology and progression of arterial stiffness. This review summarizes data from epidemiological and interventional studies on the effect of polyphenols on vascular stiffness as an illustration of current research and addresses possible etiological factors targeted by polyphenols, including pathways of vascular functionality, oxidative status, inflammation, glycation, and autophagy. Effects can either be inflicted directly by the dietary polyphenols or indirectly by metabolites originated from the host or microbial metabolic processes. The composition of the gut microbiome, therefore, determines the resulting metabolome and, as a consequence, the observed activity. On the other hand, polyphenols also influence the intestinal microbial composition, and therefore the metabolites available for interaction with relevant targets. As such, targeting the gut microbiome is another potential treatment option for arterial stiffness.
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Affiliation(s)
- Tess De Bruyne
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
| | - Bieke Steenput
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
| | - Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, 2610 Antwerpen, Belgium.
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, 2610 Antwerpen, Belgium.
| | - Claudia Nunes Dos Santos
- Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2780-901 Oeiras, Portugal.
- Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Av. da República, 2780-157 Oeiras, Portugal.
- CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Kateřina Valentová
- Institute of Microbiology of the Czech Academy of Sciences, Vídeňská 1083, 142 20 Prague, Czech Republic.
| | - Maija Dambrova
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, LV-1006 Riga, Latvia.
| | - Nina Hermans
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
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50
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Piccand E, Vollenweider P, Guessous I, Marques-Vidal P. Association between dietary intake and inflammatory markers: results from the CoLaus study. Public Health Nutr 2019; 22:498-505. [PMID: 30333073 PMCID: PMC10260662 DOI: 10.1017/s1368980018002355] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/18/2018] [Accepted: 08/07/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the associations between single foods, nutrients, dietary patterns and dietary scores, and inflammatory markers (C-reactive protein (CRP), IL-6, TNF-α and leucocyte count). DESIGN Cross-sectional, population-based study. SETTING City of Lausanne, Switzerland, years 2009-2012. SUBJECTS Adults (n 4027; 46·5 % men), mean age 57·2 (sd 10·2) years. Dietary intake was collected using a semi-quantitative FFQ. Single foods and nutrients, three dietary patterns ('Meat & fries'; 'Fruits & vegetables'; 'Fatty & sugary') and three dietary scores (two Mediterranean; Alternative Healthy Eating Index (AHEI)) were used. Associations were assessed using correlation and multivariable linear regression. RESULTS After adjusting for total energy intake, gender and other sociodemographic factors, no individual macro- or micronutrient was associated with inflammatory markers. Among single foods, only fruit intake was negatively associated with CRP levels (standardized regression score=-0·043, P<0·01). The 'Fruits & vegetables' pattern, the Mediterranean and the AHEI scores were negatively associated with CRP levels (standardized regression score=-0·079, -0·043 and -0·067, respectively, all P<0·01). When entered simultaneously with fruit intake, the 'Fruits & vegetables' pattern, the Mediterranean and the AHEI scores tended to remain significantly and negatively associated with CRP levels, while the association with fruit intake was no longer significant. No association between all dietary markers and IL-6, TNF-α or leucocyte count was found. CONCLUSIONS Dietary scores, but not individual foods, are associated with inflammatory markers in the general population.
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Affiliation(s)
- Eva Piccand
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011Lausanne, Switzerland
| | - Idris Guessous
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Community Medicine, Preventive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011Lausanne, Switzerland
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